KODY KURTIS TEW

IDAHO FALLS, ID
NPI1760724744
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: ID  PA-1057)
Enumeration Date2013-03-18
Last Update Date2013-03-18
Business Address
-- KODY KURTIS TEW PA-c
2088 E 25TH ST
IDAHO FALLS, ID 83404-6490
Phone number: 208-528-7655
Mailing Address
-- KODY KURTIS TEW PA-c
2088 E 25TH ST
IDAHO FALLS, ID 83404-6490
Phone number: 208-528-7655
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