Individual
KAYLER DETMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
775 POLE LINE RD W STE 105, TWIN FALLS, ID 83301-5819
(208) 814-8000
(208) 733-9402
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2616
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2022
Last updated
11/21/2023
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