Individual
STUART COLDSNOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1907 S BROADWAY AVE STE 101, BOISE, ID 83706-4229
(208) 345-1222
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1927
ID
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/02/2020
Last updated
09/10/2020
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