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1710616040
EMILY WIESE
MERIDIAN, ID
NPI
1710616040
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Other Name
EMMA WIESE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-2650)
Enumeration Date
2022-06-10
Last Update Date
2023-12-13
Business Address
EMILY WIESE PA-C
2347 E GALA ST STE 150
MERIDIAN, ID 83642-4881
Phone number: 208-345-3530
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Mailing Address
EMILY WIESE PA-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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