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Individual

MRS. ALICIA R BORST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.C.

Contact information

Practice address
3960 W. WAINWRIGHT, BOISE, ID 83713
(208) 384-9023
(208) 388-1683
Mailing address
3960 W. WAINWRIGHT, BOISE, ID 83713
(208) 384-9023
(208) 388-1683

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
787
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0078PA
SC
Enumeration date
04/26/2006
Last updated
04/03/2013
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