Kim Glenn, PA

NPI #1891972568 in Lewiston, Idaho

Provider Information

NPI Number: 1891972568
Entity Type: Individual
Name: Kim Glenn, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jan 24, 2008
Last Updated: Jan 24, 2008

Practice Location

Address: 415 6TH ST
City: Lewiston
State: Idaho
ZIP Code: 83501-2431
Phone: (208) 743-2511

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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