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1861737371
TYSON R JAKOBSON
BOISE, ID
NPI
1861737371
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID Pend)
Enumeration Date
2012-12-10
Last Update Date
2012-12-10
Business Address
-- TYSON R JAKOBSON PA-C
600 N ROBBINS RD #401
BOISE, ID 83702-4565
Phone number: 208-383-0201
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Mailing Address
-- TYSON R JAKOBSON PA-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2222
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