Individual
MR. CODY J SCRIVNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10798 W OVERLAND RD, BOISE, ID 83709-1329
(208) 377-3368
(208) 322-4691
Mailing address
10798 W OVERLAND RD, BOISE, ID 83709-1329
(208) 377-3368
(208) 322-4691
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/28/2016
Last updated
10/28/2016
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