Individual
KELCEE KEYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1705 N COLE RD, BOISE, ID 83704-7304
(208) 410-7548
Mailing address
1705 N COLE RD, BOISE, ID 83704-7304
(208) 410-7548
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MASG597
ID
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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