Most Relevant Information
Provider Data
NPI Number: | 1003546276 |
Provider Name: | MALINDA PAIGE WESTENDORF |
Entity Type: | Individual |
Taxonomy Code: | 363A00000X |
Specialty: | Physician Assistant |
License Number: |
Most Important Dates
Enumeration Date: | 06/12/2022 |
Last Updated: | 10/26/2022 |
Provider Practice Location
465 MCKENNA DR
MOUNTAIN HOME
ID
836472143
Practice Location Phone/Fax
Phone: | 2085879703 |
Fax: |
Provider Mailing Location
190 E BANNOCK ST
BOISE
ID
837126241
Provider Mailing Phone/Fax
Phone: | 2083818866 |
Fax: |