Individual
MISS KYRSTEN M WOOLDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
142 RIVER VISTA PL, TWIN FALLS, ID 83301-3056
(208) 734-7246
Mailing address
142 RIVER VISTA PL, TWIN FALLS, ID 83301-3056
(208) 734-7246
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
118
ID
122400000X
Denturist
Primary
LD-118
ID
122400000X
Denturist
—
—
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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