Individual
COLIN BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
13500 S. PLEASANT VALLEY, KUNA, ID 83634
(208) 922-8312
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
51458
CA
363A00000X
Physician Assistant
Primary
PA-1176
ID
Other
Enumeration date
04/10/2014
Last updated
03/10/2023
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