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Individual

MR. MARK PATRICK SMYLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2300
(208) 262-2390
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 664-2175
(208) 664-1226

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
08/27/2019
Last updated
06/04/2026
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