AUTUMN L MARTIN

BOISE, ID
NPI1578043865
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence:   PA-1632)
Enumeration Date2018-08-16
Last Update Date2022-03-16
Business Address
Miss AUTUMN L MARTIN PA
500 W FORT ST # 111
BOISE, ID 83702-4501
Phone number: 208-422-1000
Mailing Address
Miss AUTUMN L MARTIN PA
2150 E STAR LN
MERIDIAN, ID 83646-5516
Phone number: 208-484-3740
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