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1548201007
TISH D DAVIS
MERIDIAN, ID
NPI
1548201007
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA1576)
Enumeration Date
2006-06-08
Last Update Date
2019-07-22
Business Address
TISH D DAVIS PA-C
2235 E GALA ST
MERIDIAN, ID 83642-8026
Phone number: 208-887-3724
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Mailing Address
TISH D DAVIS PA-C
425 W BANNOCK ST
BOISE, ID 83702-6035
Phone number: 208-343-1702
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