Individual
KYLE SAMUEL AMBURGEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1820 E 17TH ST STE 330, IDAHO FALLS, ID 83404-6400
(909) 567-7901
Mailing address
275 PLANTATION CIR, IDAHO FALLS, ID 83404-7990
(909) 567-7901
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ID
Other
Enumeration date
09/20/2025
Last updated
09/20/2025
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