KACEY BLEA

BOISE, ID
NPI1205561727
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-2652)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
363A00000X Physician Assistant
(Licence: ID  1214536)
Enumeration Date2022-07-19
Last Update Date2024-01-17
Business Address
KACEY BLEA
100 E IDAHO ST
BOISE, ID 83712-6267
Phone number: 208-381-4171
Mailing Address
KACEY BLEA
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-8749