Individual
SERENA RAQUEL ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2990 CORTEZ AVE, IDAHO FALLS, ID 83404-7554
(208) 535-0440
(208) 535-0550
Mailing address
2990 CORTEZ AVE, IDAHO FALLS, ID 83404-7554
(208) 535-0440
(208) 535-0550
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA634
ID
Other
Enumeration date
11/13/2006
Last updated
01/23/2008
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