Tyson Anderson Cluff PA-C

NPI 1023253754 - Physician Assistant - 363AM0700X

NPI Details
NPI 1023253754
Gender Male
Enumeration Date 12/09/2008
Last Updated 06/16/2011
Entity Type Individual
Active Over 8 years ago
Practice Location
MALAD CITY ID, 83252-1256, US
Phone (208) 766-2600
Fax (208) 766-2342
Business Location
PO BOX 126
MALAD CITY ID, 83252-0126, US
Phone (208) 766-2231
Fax (208) 766-4819
Taxonomy Code 363AM0700X
License State Idaho
License Number PA-784
Remove 1023253754 NPI Number

According to our database, Mr. Tyson Anderson Cluff PA-C NPI is 1023253754, taxonomy code is 363AM0700X and license number is PA-784, license state is located at Idaho. Tyson Anderson Cluff PA-C physically located at 220 Bannock St, Malad City ID, 83252-1256. NPI Number Tyson Anderson Cluff PA-C has the Individual type.

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1023253754 NPI number is provided on an as is basis without warranty of any kind. 1023253754 is maintained by the National Plan & Provider Enumeration System. The contents of Tyson Anderson Cluff PA-C are for informational purposes only.