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1487904280
MICHAEL ROBERT NIERAETH
BOISE, ID
NPI
1487904280
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: ID PA-993)
Enumeration Date
2012-09-19
Last Update Date
2019-03-25
Business Address
Mr. MICHAEL ROBERT NIERAETH PA
8854 W EMERALD ST STE 102
BOISE, ID 83704
Phone number: 208-323-4747
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Mailing Address
Mr. MICHAEL ROBERT NIERAETH PA
8854 W EMERALD ST STE 102
BOISE, ID 83704-4845
Phone number: 208-323-4747
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