Individual
JONATHAN T ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
8181 N CORNERSTONE DR, HAYDEN, ID 83835-8752
(208) 772-0785
Mailing address
8181 N CORNERSTONE DR, HAYDEN, ID 83835-8752
(208) 772-0785
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2485
ID
Other
Enumeration date
08/11/2011
Last updated
03/13/2024
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