Individual
MR. BRENTON JAMES NOEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
381 S MIDDLETON RD STE B, MIDDLETON, ID 83644-5369
(208) 585-6311
Mailing address
PO BOX 277976, ATLANTA, GA 30384-7976
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1102
ID
Other
Enumeration date
10/22/2013
Last updated
10/28/2022
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