Individual
RYAN THEODORE CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
999 N CURTIS RD STE 415, BOISE, ID 83706-1334
(208) 302-2600
(208) 302-2625
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9171373
ID
363A00000X
Physician Assistant
—
—
Other
Enumeration date
03/01/2023
Last updated
08/25/2025
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