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1114405396
RYAN BLAIR KILLPACK
BLACKFOOT, ID
NPI
1114405396
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
Additional Taxonomies
363AS0400X Physician Assistant, Surgical
Enumeration Date
2018-07-31
Last Update Date
2018-07-31
Business Address
RYAN BLAIR KILLPACK PA-C
98 POPLAR ST
BLACKFOOT, ID 83221-1758
Phone number: 208-785-4100
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Mailing Address
RYAN BLAIR KILLPACK PA-C
98 POPLAR ST
BLACKFOOT, ID 83221-1758
Phone number: 208-785-4100
Copy
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