Individual
TRAVIS DALE WORWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4949 S HILLSDALE AVE, MERIDIAN, ID 83642-7586
(208) 706-6400
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2175
ID
Other
Enumeration date
07/20/2018
Last updated
02/13/2024
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