Individual
KAYLIE SYLVESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 FOREST ST, MCCALL, ID 83638-5256
(208) 630-2470
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(509) 482-4040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA.60941453
WA
363A00000X
Physician Assistant
Primary
PA-2553
ID
363A00000X
Physician Assistant
PA60941453
WA
Other
Enumeration date
05/06/2019
Last updated
08/08/2023
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