AUDRA J ROSE

IDAHO FALLS, ID
NPI1487877619
Former NameAUDRA J ROSE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207V00000X Obstetrics & Gynecology
(Licence: ID  M6628)
Additional Taxonomies363A00000X Physician Assistant
(Licence: WY  TL403)
Enumeration Date2007-04-10
Last Update Date2023-12-29
Business Address
AUDRA J ROSE PA
3450 POTOMAC WAY
IDAHO FALLS, ID 83404-7407
Phone number: 208-557-2900
Mailing Address
AUDRA J ROSE PA
3450 POTOMAC WAY
IDAHO FALLS, ID 83404-4970
Phone number: 208-557-2900