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1760724744
KODY KURTIS TEW
IDAHO FALLS, ID
NPI
1760724744
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA-1057)
Enumeration Date
2013-03-18
Last Update Date
2013-03-18
Business Address
-- KODY KURTIS TEW PA-c
2088 E 25TH ST
IDAHO FALLS, ID 83404-6490
Phone number: 208-528-7655
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Mailing Address
-- KODY KURTIS TEW PA-c
2088 E 25TH ST
IDAHO FALLS, ID 83404-6490
Phone number: 208-528-7655
Copy
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