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Individual

MICHAEL P KLETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1252 BENNETT AVE., STE B, BURLEY, ID 83318-2664
(208) 878-5255
(208) 878-2005
Mailing address
1252 BENNETT AVE., STE B, BURLEY, ID 83318-2664
(208) 878-5255
(208) 878-2005

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-30
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004312800
ID
Enumeration date
08/29/2006
Last updated
03/01/2012
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