Individual
GREG LYLE KLINGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
32 W 1ST S, REXBURG, ID 83440-1810
(208) 356-7585
Mailing address
32 W 1ST S, REXBURG, ID 83440-1810
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-836
ID
Other
Enumeration date
05/09/2008
Last updated
01/25/2010
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