Individual
THOMAS DANIEL FIFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
611 CLINIC RD, CHALLIS, ID 83226
(208) 879-4351
(208) 879-5216
Mailing address
611 CLINIC RD, CHALLIS, ID 83226
(208) 879-4351
(208) 879-5216
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-1371
ID
Other
Enumeration date
06/01/2016
Last updated
07/21/2020
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