Kyle Phillip Dietrich, PA STUDENT

NPI #1932661352 in Pocatello, Idaho

Provider Information

NPI Number
1932661352
Entity Type
Individual
Name
Kyle Phillip Dietrich, PA STUDENT
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Student in an Organized Health Care Education/Training Program
Credential
PA STUDENT
Enumeration Date
Apr 3, 2019
Last Updated
May 5, 2024

Practice Location

Address
921 S 8TH AVE STOP 8253
State
Idaho
ZIP Code
83209-0002
Phone
(208) 282-4726

Specialties & Taxonomy Codes

Specialty
Massage Therapist
Student in an Organized Health Care Education/Training Program

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