Individual
KYLEE RICHMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
507 S MAIN ST, HAILEY, ID 83333-8929
(208) 788-4122
Mailing address
PO BOX 4341, HAILEY, ID 83333-4341
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/21/2019
Last updated
08/25/2022
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