Individual
CLAYTON KLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
881 E 3900 N, BUHL, ID 83316-5929
(208) 308-6841
Mailing address
881 E 3900 N, BUHL, ID 83316-5929
(208) 308-6841
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085008738
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/15/2020
Last updated
01/04/2022
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