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LANCE PORT, PA-C

PA-C

Medical Physician Assistant

NPI: 1578222188IndividualAccepts Medicare

Specialties, Licenses & Credentials

Medical Physician AssistantPrimary

Physician Assistant — Medical

Code: 363AM0700X

CMS Specialties

Education

OTHER

Class of 2021

Contact & Hours

Address
103 S DAISY ST
SALMON, ID 83467

Quick Facts

NPI
1578222188
Entity Type
Individual
Gender
Male
Medicare
Accepted
Specialties
1
Locations
1
Years in Practice
5

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