JAMES PICANCO

FORT HALL, ID
NPI1407862139
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: TX  PA01153)
Enumeration Date2006-08-01
Last Update Date2007-07-18
Business Address
Mr. JAMES PICANCO P.A.-C
MISSION ROAD
FORT HALL, ID 83203-0717
Phone number: 208-238-5427
Mailing Address
Mr. JAMES PICANCO P.A.-C
MISSION ROAD
FORT HALL, ID 83203-0717
Phone number: 208-238-5427
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