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1407537400
JOSHUA SHANE BLANCHARD
POCATELLO, ID
NPI
1407537400
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-2561)
Enumeration Date
2023-07-31
Last Update Date
2023-07-31
Business Address
JOSHUA SHANE BLANCHARD PA-C
495 YELLOWSTONE AVE
POCATELLO, ID 83201-4531
Phone number: 208-478-7422
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Mailing Address
JOSHUA SHANE BLANCHARD PA-C
4666 PAHSIMEROI DR
POCATELLO, ID 83202-4959
Phone number:
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