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1598861379
MICHAEL L MART
BOISE, ID
NPI
1598861379
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA77)
Enumeration Date
2006-09-16
Last Update Date
2017-03-07
Business Address
Mr. MICHAEL L MART PAC
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-706-7500
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Mailing Address
Mr. MICHAEL L MART PAC
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-706-7500
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