Individual
MR. JAMES LEE BURRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
500 W. FORT ST., # 111, BOISE, ID 83702
(208) 422-1000
(208) 422-1319
Mailing address
13153 W PAINT DR, BOISE, ID 83713-1928
(208) 918-2336
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-991
ID
Other
Enumeration date
07/30/2012
Last updated
03/15/2022
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