Individual
DALE CARLSON KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
518 OAK ST, KAMIAH, ID 83536
(208) 935-2585
Mailing address
518 OAK ST, KAMIAH, ID 83536
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M-17354
ID
Other
Enumeration date
03/31/2020
Last updated
08/18/2023
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