Individual
CHAD COON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2210 CORONADO ST, IDAHO FALLS, ID 83404-7430
(208) 522-3355
(208) 522-6019
Mailing address
2210 CORONADO ST, IDAHO FALLS, ID 83404-7430
(208) 522-3355
(208) 522-6019
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9653019-1206
UT
Other
Enumeration date
01/12/2016
Last updated
09/01/2021
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