Individual
KYLA MEGAN WOOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2619 W FAIRVIEW AVE STE 2100, BOISE, ID 83702-6722
(208) 706-2663
(208) 489-4300
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2018002195
MO
363A00000X
Physician Assistant
Primary
PA-1906
ID
Other
Enumeration date
01/26/2018
Last updated
09/25/2024
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