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Individual

MR. RYAN CASEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1648 NW 1ST ST, MERIDIAN, ID 83642-2212
(208) 888-9393
(208) 888-9525
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 985-1423
(208) 955-6501

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
07/10/2023
Last updated
04/24/2024
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