KODY RAY GOULD

BLACKFOOT, ID
NPI1750046983
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-2158)
Enumeration Date2021-11-02
Last Update Date2021-11-02
Business Address
KODY RAY GOULD PA
1350 PARKWAY DR
BLACKFOOT, ID 83221-1657
Phone number: 208-782-2410
Mailing Address
KODY RAY GOULD PA
1860 S 2ND AVE APT 24
POCATELLO, ID 83201-6874
Phone number: 253-620-0072
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