Graduated: 2024
NPI: 1457133977
Practice Locations (3)
IDAHO SKIN SURGERY CENTER PC
1906 S VISTA AVE
BOISE, ID 837053453
IDAHO SKIN SURGERY CENTER PC
1906 S VISTA AVE, SUITE A
BOISE, ID 837053453
2084331114
ISSC FRUITLAND
811 NW 12TH ST
FRUITLAND, ID 836192268
2084527450
Source: CMS National Downloadable File, September 2026.