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Individual

MR. AUSTIN HEATH RASMUSSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
637 PINE ST, GOODING, ID 83330-1755
(208) 934-8390
Mailing address
637 PINE ST, GOODING, ID 83330-1755
(208) 934-8390

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
60236691
WA
363AM0700X
Medical Physician Assistant
Primary
PA-1045
ID
363AM0700X
Medical Physician Assistant

Other

Enumeration date
07/23/2011
Last updated
04/23/2013
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