Individual
MR. NICHOLAS EUGENE GARVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
300 S 23RD ST, BOISE, ID 83702-9100
(208) 344-3512
(208) 344-4898
Mailing address
300 S 23RD ST, BOISE, ID 83702-9100
(970) 319-9539
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1364
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA-1364
STATE LICENSE
ID
Enumeration date
09/26/2012
Last updated
04/14/2016
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