Individual
JOSHUA GERALD TEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 528-7655
(208) 524-9390
Mailing address
2100 ALAN ST, IDAHO FALLS, ID 83404-5801
(208) 528-7655
(208) 524-9390
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA-1244
ID
363A00000X
Physician Assistant
8930965-1206
UT
Other
Enumeration date
02/10/2014
Last updated
02/07/2022
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