KATIE DIANE MADDOCK

IDAHO FALLS, ID
NPI1275261059
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2022-08-10
Last Update Date2024-11-23
Business Address
KATIE DIANE MADDOCK
1550 ELK CREEK DR
IDAHO FALLS, ID 83404-8322
Phone number: 208-529-5942
Mailing Address
KATIE DIANE MADDOCK
1550 ELK CREEK DR
IDAHO FALLS, ID 83404-8322
Phone number: 208-529-5942
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