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1972950210
MICHAEL ALLAN HALLSTROM
BOISE, ID
NPI
1972950210
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2016-05-17
Last Update Date
2018-03-17
Business Address
MICHAEL ALLAN HALLSTROM PA-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-5015
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Mailing Address
MICHAEL ALLAN HALLSTROM PA-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-5015
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