Individual
TOMAS JON SCOLERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
775 POLE LINE RD W STE 213, TWIN FALLS, ID 83301-5820
(208) 814-8475
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2303
ID
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/17/2022
Last updated
09/08/2022
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