Individual
KYLE WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
190 W MAIN ST, KUNA, ID 83634
(208) 962-1849
Mailing address
PO BOX 164, KUNA, ID 83634-0164
(208) 962-1849
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
006550
NY
171100000X
Acupuncturist
Primary
ACU-361
ID
Other
Enumeration date
06/19/2019
Last updated
11/30/2023
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