Graduated: 2021
NPI: 1841868148
Practice Locations (3)
CATALDO, ID 83810
2088199470
123 MCKINLEY AVE
KELLOGG, ID 838372501
2064866239
SHOSHONE MEDICAL CENTER
25 JACOBS GULCH RD
KELLOGG, ID 838372023
2087841227
Source: CMS National Downloadable File, September 2026.