Individual
MS. KELLY SUE CARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
220 WARREN AVE, POCATELLO, ID 83201-4639
(707) 714-9206
Mailing address
220 WARREN AVE, POCATELLO, ID 83201-4639
(707) 714-9206
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
ID
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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