MR. Leroy Keith Van Dyke, PA

NPI #1306842307 in Moses Lake, Washington

Provider Information

NPI Number: 1306842307
Entity Type: Individual
Name: MR. Leroy Keith Van Dyke, PA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jun 23, 2005
Last Updated: Jan 18, 2024

Practice Location

Address: 3322 ROAD N NE
City: Moses Lake
State: Washington
ZIP Code: 98837-9505
Phone: (509) 793-9051

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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