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Individual

KYREN TWEEDIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3160 E 17TH ST STE 164, AMMON, ID 83406-6784
(208) 529-1795
Mailing address
1500 E VENTURE WAY APT 9206, POCATELLO, ID 83201-1209
(208) 716-8547

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
I71317
ID

Other

Enumeration date
09/18/2025
Last updated
10/24/2025
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