RYAN BLAIR KILLPACK

BLACKFOOT, ID
NPI1114405396
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
Additional Taxonomies363AS0400X Physician Assistant, Surgical
Enumeration Date2018-07-31
Last Update Date2018-07-31
Business Address
RYAN BLAIR KILLPACK PA-C
98 POPLAR ST
BLACKFOOT, ID 83221-1758
Phone number: 208-785-4100
Mailing Address
RYAN BLAIR KILLPACK PA-C
98 POPLAR ST
BLACKFOOT, ID 83221-1758
Phone number: 208-785-4100
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