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Individual

PHILLIP MARLOWE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3422 S 15TH E, IDAHO FALLS, ID 83404-8262
(208) 529-9292
Mailing address
3422 S 15TH E, IDAHO FALLS, ID 83404-8262
(208) 529-9292

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1886
ID

Other

Enumeration date
07/02/2019
Last updated
06/08/2021
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