Individual
CHARLES EDWARD BRIOSCHI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
910 NW 16TH STREET, STE 205, FRUITLAND, ID 83619-2265
(208) 452-3111
(208) 452-3666
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 452-3111
(208) 452-3666
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-1317
ID
Other
Enumeration date
10/20/2015
Last updated
02/17/2016
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