MICHAEL KENNETH WUCINICH

TWIN FALLS, ID
NPI1407223274
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: ID  1274)
Enumeration Date2015-08-28
Last Update Date2015-11-19
Business Address
Mr. MICHAEL KENNETH WUCINICH PA-C
775 POLE LINE RD W STE 302
TWIN FALLS, ID 83301-5823
Phone number: 208-814-8725
Mailing Address
Mr. MICHAEL KENNETH WUCINICH PA-C
3724 E 3770 N
KIMBERLY, ID 83341-5524
Phone number: 208-420-8188