LEROY KEITH VAN DYKE

MOSES LAKE, WA
NPI1306842307
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: WA  PA10003296)
Enumeration Date2005-06-23
Last Update Date2024-01-18
Business Address
Mr. LEROY KEITH VAN DYKE PA
3322 ROAD N NE
MOSES LAKE, WA 98837-9505
Phone number: 509-793-9051
Mailing Address
Mr. LEROY KEITH VAN DYKE PA
3322 ROAD N NE
MOSES LAKE, WA 98837-9505
Phone number: 509-793-9051
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