Individual
MITCHELL JENTZSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6471595
ID
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/04/2025
Last updated
02/12/2026
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