TAKAHISA KOIDE

NAMPA, ID
NPI1508514456
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-2208)
Enumeration Date2022-03-10
Last Update Date2022-03-10
Business Address
TAKAHISA KOIDE PA
700 CALDWELL BLVD
NAMPA, ID 83651-1707
Phone number: 208-466-6567
Mailing Address
TAKAHISA KOIDE PA
PO BOX 191050
BOISE, ID 83719-1050
Phone number: 208-955-6500
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