Individual
MR. NICHOLAS WADE BOZARTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1101 E POLSTON AVE STE B, POST FALLS, ID 83854-6045
(208) 747-1776
(208) 747-1777
Mailing address
1101 E POLSTON AVE STE B, POST FALLS, ID 83854-6045
(208) 747-1776
(208) 747-1777
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-2131
ID
Other
Enumeration date
09/16/2014
Last updated
01/08/2026
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