Individual
BENNETT BRIARD HOFMEISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 S EAGLE RD, MERIDIAN, ID 83642-6351
(208) 706-5000
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-2416
ID
363AM0700X
Medical Physician Assistant
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Other
Enumeration date
10/26/2022
Last updated
02/01/2023
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