Individual
KALEB REDDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
O-0995
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366822892
—
ID
Enumeration date
05/29/2015
Last updated
06/19/2019
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