LISA A BOSWORTH

POCATELLO, ID
NPI1730372756
Former NameLISA A PODANY
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-692)
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2007-08-22
Last Update Date2024-02-14
Business Address
LISA A BOSWORTH PA
1951 BENCH RD STE B
POCATELLO, ID 83201-2073
Phone number: 208-238-1000
Mailing Address
LISA A BOSWORTH PA
1951 BENCH RD
POCATELLO, ID 83201-2013
Phone number: 208-239-1000