Individual
CLYDE L. KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2360 MULLAN RD STE C, MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-6053
Mailing address
2360 MULLAN RD STE C, MISSOULA, MT 59808-1811
(406) 721-4436
(406) 721-6053
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
20186
MT
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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