Individual
JOHNNY GARCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CST
Contact information
Practice address
8800 W EMERALD ST, BOISE, ID 83704-8205
(208) 373-5000
Mailing address
10422A W GLEN ELLYN CT, BOISE, ID 83704-5440
(208) 761-1239
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
189048
ID
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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