SOPHIA NYSWYN

MERIDIAN, ID
NPI1720356363
Former NameANNIE SOPHIA GLADSTON SOLOMON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA941)
Enumeration Date2011-12-10
Last Update Date2011-12-10
Business Address
-- SOPHIA NYSWYN PA
520 S EAGLE RD STE 3112
MERIDIAN, ID 83642-6351
Phone number: 208-706-5800
Mailing Address
-- SOPHIA NYSWYN PA
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2222
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