Individual
KEILY MAYA TOMCHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1550 ELK CREEK DR, IDAHO FALLS, ID 83404-8322
(208) 524-6308
Mailing address
1550 ELK CREEK DR, IDAHO FALLS, ID 83404-8322
(208) 529-5942
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5071491
ID
Other
Enumeration date
08/14/2022
Last updated
01/06/2026
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