Individual
MR. MARVIN CHARLES SPARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS PA-C
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1136
(208) 422-1243
Mailing address
110 S COTTERELL DR, BOISE, ID 83709-0307
(208) 322-4468
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-35
ID
Other
Enumeration date
08/12/2006
Last updated
07/08/2007
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