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Organization

EVENING MEDICAL CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL P KLETT DO (OWNER)
(208) 878-5255
Entity
Organization

Contact information

Practice address
1252 BENNETT AVE, SUITE B, BURLEY, ID 83318
(208) 878-3486
(208) 878-2005
Mailing address
1252 BENNETT AVE, SUITE B, BURLEY, ID 83318
(208) 878-3486
(208) 878-2005

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Enumeration date
06/01/2007
Last updated
07/16/2010
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