Individual
KYLIE PEETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
805 MAIN ST, SALMON, ID 83467-4316
(208) 756-6212
Mailing address
21 WITHINGTON CREEK RD, SALMON, ID 83467-4905
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1561371
ID
Other
Enumeration date
06/20/2024
Last updated
09/29/2024
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