Kelly Marie Landle, P.A.-C

NPI #1497723217 in Kendrick, Idaho

Provider Information

NPI Number: 1497723217
Entity Type: Individual
Name: Kelly Marie Landle, P.A.-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.-C
Enumeration Date: Mar 8, 2006
Last Updated: Apr 16, 2019

Practice Location

Address: 606 E MAIN ST
City: Kendrick
State: Idaho
ZIP Code: 83537
Phone: (208) 289-3841

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary
Physician Assistant - Surgical — Surgical	363AS0400X
Physician Assistant - Medical — Medical	363AM0700X

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