Individual
JASON E KOLB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1075 N CURTIS RD, STE 201, BOISE, ID 83706
(208) 302-3300
(208) 302-3355
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642
(208) 302-3300
(208) 302-3355
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1545
ID
363A00000X
Physician Assistant
PA202158
OR
Other
Enumeration date
10/10/2017
Last updated
01/25/2021
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