Individual
SAM JENSEN WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2725 CHANNING WAY, IDAHO FALLS, ID 83404-7510
(208) 525-8448
Mailing address
2725 CHANNING WAY, IDAHO FALLS, ID 83404-7510
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-2117
ID
Other
Enumeration date
09/30/2021
Last updated
09/30/2021
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