Individual
KYLE LANCE HOLSTED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1 MEDICAL CENTER DRIVE, DEPARTMENT OF SURGERY, LEBANON, NH 03756-0001
(603) 650-8537
Mailing address
1 MEDICAL CENTER DRIVE, DEPARTMENT OF SURGERY, LEBANON, NH 03756-0001
(603) 650-8537
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1492
NH
Other
Enumeration date
04/19/2019
Last updated
09/05/2019
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