Individual
MR. JUDE BOUTKASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
413 ALLUMBAUGH ST, SUITE 101, BOISE, ID 83704-9212
(208) 362-6162
(208) 362-9604
Mailing address
413 ALLUMBAUGH ST, SUITE 101, BOISE, ID 83704-9212
(208) 362-6162
(208) 362-9604
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA343
ID
Other
Enumeration date
01/16/2007
Last updated
04/16/2021
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