Individual
JOSHUA D KILLPACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2442 E 25TH ST, IDAHO FALLS, ID 83404-7549
(208) 552-4909
Mailing address
2325 CORONADO ST, IDAHO FALLS, ID 83404-7407
(208) 557-2700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-985
ID
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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