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Individual

KENTON WOO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-1000
Mailing address
631 SARATOGA DR APT 203, TWIN FALLS, ID 83301-4572

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
02/11/2021
Last updated
02/11/2021
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