Southeast First Assistant LLC
Southeast First Assistant LLC is a Physician Assistant in Athol, Idaho. Licensed in Idaho. Registered with an NPI since 2015.
- Licensed in
- ID
- In the registry since
- 2015
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
12473 E Nunn RdAthol, ID 83801-9311
Phone: (208) 215-6411
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Surgical Physician Assistant (primary) | Taxonomy 363AS0400X · Licence PA-1167 (ID) |
|---|---|
| Physician Assistant | Taxonomy 363A00000X · Licence PA-1167 (ID) |
Record details
| NPI number | 1790158459 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Drew Johnson — Owner · (208) 215-6411 |
| NPI enumerated | November 3, 2015 |
| Last updated in NPPES | November 3, 2015 |
| Mailing address | 12473 E Nunn Rd, Athol, ID 83801-9311 |