Individual
HAYDEN WHEATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
402 6TH ST, RUPERT, ID 83350-1619
(208) 650-7941
Mailing address
402 6TH ST, RUPERT, ID 83350-1619
(208) 650-7941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2732
ID
Other
Enumeration date
03/27/2024
Last updated
03/27/2024
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