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1952441305
KELLEE J CROCKETT
EAGLE, ID
NPI
1952441305
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PAC636)
Enumeration Date
2007-02-07
Last Update Date
2007-07-08
Business Address
-- KELLEE J CROCKETT PA-C
1032 S BRIDGWAY PL SUITE 100
EAGLE, ID 83616
Phone number: 208-246-0123
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Mailing Address
-- KELLEE J CROCKETT PA-C
1032 S BRIDGE WAY PL SUITE 100
EAGLE, ID 83616-6099
Phone number: 208-246-0123
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