Individual
RAUL RIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
1648 NW 1ST ST, MERIDIAN, ID 83642-2212
(208) 888-9393
(208) 888-9525
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6522
(208) 955-6503
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1211
ID
363AM0700X
Medical Physician Assistant
7778571-1206
UT
363AS0400X
Surgical Physician Assistant
7778571-1206
UT
Other
Enumeration date
09/20/2010
Last updated
12/06/2021
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