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1992498497
DAVIS JORDON EVERTON
NAMPA, ID
NPI
1992498497
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-2509)
Enumeration Date
2023-05-31
Last Update Date
2023-12-08
Business Address
DAVIS JORDON EVERTON PA
1115 12TH AVE RD
NAMPA, ID 83686-5738
Phone number: 208-498-1080
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Mailing Address
DAVIS JORDON EVERTON PA
PO BOX 191050
BOISE, ID 83719-1050
Phone number:
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