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Individual

MR. NICHOLAS A. HUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
510 N 2ND ST, SUITE 103, BOISE, ID 83702-6077
(208) 381-4700
(208) 381-4977
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-901
ID

Other

Enumeration date
04/07/2011
Last updated
10/06/2012
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