Individual
TODD CRANOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1950 E CLARK ST STE 110, POCATELLO, ID 83201-3315
(208) 232-7246
Mailing address
3385 POTOMAC WAY, IDAHO FALLS, ID 83404-4978
(208) 522-7246
(208) 529-2620
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-1650
ID
363A00000X
Physician Assistant
Primary
PA56759
CA
Other
Enumeration date
11/12/2018
Last updated
11/04/2020
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