Individual
MR. MATTHEW DANIEL PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1055 N CURTIS ROAD, BOISE, ID 83706
(208) 367-7350
(208) 367-3951
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642
(208) 367-7350
(208) 367-3951
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA- 1469
ID
Other
Enumeration date
02/08/2017
Last updated
11/16/2017
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