Organization · Type 2 NPI
Southeast First Assistant LLC
Surgical Physician Assistant · Athol, ID
NPI number
1790158459
Active
Practice location
12473 E Nunn Rd
Athol, ID 83801-9311
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | PA-1167 (ID) |
| Surgical Physician Assistant Primary | 363AS0400X | PA-1167 (ID) |
Surgical Physician Assistant: Definition to come...
About NPI 1790158459
Southeast First Assistant LLC's National Provider Identifier is 1790158459, issued on Nov 3, 2015. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Athol, ID. The record was last updated on Nov 3, 2015.