Individual
JORDAN ALAN RESNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-7350
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642-1026
(208) 302-9342
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M-16448
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/03/2017
Last updated
06/03/2022
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