Individual
TROY D WESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
120 E HOWARD ST, TETON VALLEY HEALTH CARE, DRIGGS, ID 83422-5112
(208) 354-6302
(208) 354-3158
Mailing address
120 E HOWARD ST, TETON VALLEY HEALTH CARE, DRIGGS, ID 83422-5112
(208) 354-6302
(208) 354-3158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 212
ID
363AM0700X
Medical Physician Assistant
Primary
PA212
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806633300
—
ID
01
—
PASRO
BLUE CROSS
ID
Enumeration date
01/24/2006
Last updated
11/04/2016
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