Tara C Rothwell PA

NPI 1912087438 - Physician Assistant - 363A00000X

NPI Details
NPI 1912087438
Gender Female
Enumeration Date 10/17/2006
Last Updated 11/29/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
6052 W STATE ST
BOISE ID, 83703-2739, US
Phone (208) 344-7799
Fax (208) 344-7152
Business Location
PO BOX 191050
SUITE 115
BOISE ID, 83719-1050, US
Phone (208) 955-6500
Fax (208) 955-6503
Toxanomy
Taxonomy Code 363A00000X
License State Nevada
License Number PA574
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According to our database, Tara C Rothwell PA NPI is 1912087438, taxonomy code is 363A00000X and license number is PA574, license state is located at Nevada. Tara C Rothwell PA physically located at 6052 W State St, Boise ID, 83703-2739. NPI Number Tara C Rothwell PA has the Individual type.

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1912087438 NPI number is provided on an as is basis without warranty of any kind. 1912087438 is maintained by the National Plan & Provider Enumeration System. The contents of Tara C Rothwell PA are for informational purposes only.