EVAN DAYNE IVIE PA
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1558765891- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PA
- Status
- Active
Contact & Location
- Address
- 3456 E 17TH ST STE 190, AMMON, ID, 834066749
- Phone
- (208) 524-2222
- Fax
- (855) 999-9242
Specialties & Taxonomies
Physician Assistant
Primary License: ID #PA-1265