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1720502917
ALFONSO JR HERNANDEZ
BLACKFOOT, ID
NPI
1720502917
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-1530)
Enumeration Date
2017-07-28
Last Update Date
2018-02-22
Business Address
Mr. ALFONSO JR HERNANDEZ PA-C
466 HORROCKS DR
BLACKFOOT, ID 83221-3452
Phone number: 307-399-5925
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Mailing Address
Mr. ALFONSO JR HERNANDEZ PA-C
466 HORROCKS DR
BLACKFOOT, ID 83221-3452
Phone number:
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