Individual
MRS. PEYTON M FARRALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
222 N 2ND ST STE 215, BOISE, ID 83702-6130
(208) 381-5500
(208) 381-2555
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8752
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
6261174
ID
Other
Enumeration date
07/18/2022
Last updated
09/10/2024
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