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1669299152
JAY PHAN
TWIN FALLS, ID
NPI
1669299152
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: ID 3561779)
Enumeration Date
2024-09-25
Last Update Date
2024-09-25
Business Address
JAY PHAN
419 SHOUP AVE W
TWIN FALLS, ID 83301-5028
Phone number: 209-996-1700
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Mailing Address
JAY PHAN
604 LYNWOOD BLVD
TWIN FALLS, ID 83301-4133
Phone number:
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