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Individual

MR. KARL M LETKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPAS, PA-C

Contact information

Practice address
500 S 11TH AVE, SUITE 503, POCATELLO, ID 83201-4835
(208) 239-1710
(208) 239-1713
Mailing address
500 S 11TH AVE, SUITE 503, POCATELLO, ID 83201-4835
(208) 239-1710
(208) 239-1713

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-916
ID
363AM0700X
Medical Physician Assistant
PA21368
CA

Other

Enumeration date
12/07/2010
Last updated
11/10/2011
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