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1578043865
AUTUMN L MARTIN
BOISE, ID
NPI
1578043865
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: PA-1632)
Enumeration Date
2018-08-16
Last Update Date
2022-03-16
Business Address
Miss AUTUMN L MARTIN PA
500 W FORT ST # 111
BOISE, ID 83702-4501
Phone number: 208-422-1000
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Mailing Address
Miss AUTUMN L MARTIN PA
2150 E STAR LN
MERIDIAN, ID 83646-5516
Phone number: 208-484-3740
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