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Individual

DAVID E LAISY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
750 N SYRINGA ST STE 100, POST FALLS, ID 83854-5275
(208) 262-2600
(208) 262-2700
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2498
(208) 262-7461

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2647
ID

Other

Enumeration date
10/13/2006
Last updated
07/24/2024
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