Individual
DR. KIMBERLEY D BLEWETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
623 SOUTH MAIN STREET, MOSCOW, ID 83843
(208) 882-2011
(208) 883-1853
Mailing address
623 SOUTH MAIN STREET, MOSCOW, ID 83843
(208) 882-2011
(208) 883-1853
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
66740581204
UT
Other
Enumeration date
08/16/2007
Last updated
11/17/2011
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