KELLY BEACH

BOISE, ID
NPI1649668765
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-1208)
Enumeration Date2014-12-23
Last Update Date2016-01-08
Business Address
-- KELLY BEACH PA
300 W MYRTLE ST SUITE 100
BOISE, ID 83702-7690
Phone number: 208-472-9082
Mailing Address
-- KELLY BEACH PA
PO BOX 191050
BOISE, ID 83719-1050
Phone number: 208-955-6522
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