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1730190935
ROGER SCOTT MALM
NAMPA, ID
NPI
1730190935
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA220)
Enumeration Date
2006-08-11
Last Update Date
2024-12-17
Business Address
ROGER SCOTT MALM PA
824 S DIAMOND ST
NAMPA, ID 83686-5960
Phone number: 208-606-0396
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Mailing Address
ROGER SCOTT MALM PA
824 S DIAMOND ST
NAMPA, ID 83686-5960
Phone number: 208-606-0396
Copy
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