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1689835290
LISA DAWN UPSON
BOISE, ID
NPI
1689835290
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: ID PTA 433)
Enumeration Date
2008-06-17
Last Update Date
2008-06-17
Business Address
LISA DAWN UPSON PTA
1001 S HILTON ST
BOISE, ID 83705-1925
Phone number: 208-392-7926
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Mailing Address
LISA DAWN UPSON PTA
607 S HAWTHORNE AVE
EMMETT, ID 83617-3633
Phone number: 208-392-7926
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