BRENT ANGEL ELLSWORTH

IDAHO FALLS, ID
NPI1831412063
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-844)
Enumeration Date2010-03-02
Last Update Date2022-11-02
Business Address
BRENT ANGEL ELLSWORTH PA-C
2001 S WOODRUFF AVE STE 9
IDAHO FALLS, ID 83404-6371
Phone number: 208-419-3002
Mailing Address
BRENT ANGEL ELLSWORTH PA-C
2001 S WOODRUFF AVE STE 9
IDAHO FALLS, ID 83404-6371
Phone number: 208-419-3002
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