Individual
JONATHAN AMISSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1573 S RIVERSTONE LN APT 303, BOISE, ID 83706-6542
(208) 805-9839
Mailing address
1573 S RIVERSTONE LN APT 303, BOISE, ID 83706-6542
(208) 805-9839
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
11/09/2019
Last updated
11/09/2019
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