Individual
SCOTT CORY STUART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1344 HILAND AVE STE D, BURLEY, ID 83318-1564
(208) 572-6005
(208) 261-3066
Mailing address
147 W CHUBBUCK RD, CHUBBUCK, ID 83202-2314
(208) 238-7546
(208) 237-9643
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1850
ID
Other
Enumeration date
10/09/2018
Last updated
02/20/2020
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