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TAI BANTA
Physician Assistant
NPI: 1467185843IndividualAccepts Medicare
Specialties, Licenses & Credentials
Student in an Organized Health Care Education/Training Program
Code: 390200000X
CMS Specialties
PrimaryPHYSICIAN ASSISTANT
Education
OTHER
Class of 2022
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Contact & Hours
Via practice · 3 locations total
- Address
- 14107 N 5TH E
IDAHO FALLS, ID 83401 - Phone
- (208) 881-7462
Quick Facts
- NPI
- 1467185843
- Entity Type
- Individual
- Gender
- Female
- Medicare
- Accepted
- Specialties
- 2
- Locations
- 3
- Years in Practice
- 4
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