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1588757850
COLIN SOARES
BOISE, ID
NPI
1588757850
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA505)
Enumeration Date
2006-10-01
Last Update Date
2012-12-11
Business Address
-- COLIN SOARES PA
6052 W STATE ST
BOISE, ID 83703-2739
Phone number: 208-344-7799
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Mailing Address
-- COLIN SOARES PA
PO BOX 191050
BOISE, ID 83719-1050
Phone number: 208-955-6500
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