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1891972568
KIM GLENN
LEWISTON, ID
NPI
1891972568
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-714)
Enumeration Date
2008-01-24
Last Update Date
2008-01-24
Business Address
-- KIM GLENN PA
415 6TH ST
LEWISTON, ID 83501-2431
Phone number: 208-743-2511
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Mailing Address
-- KIM GLENN PA
415 6TH ST
LEWISTON, ID 83501-2431
Phone number: 208-743-2511
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