KODY RAY GOULD PA
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1750046983- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PA
- Status
- Active
Contact & Location
- Address
- 1350 PARKWAY DR, BLACKFOOT, ID, 832211657
- Phone
- (208) 782-2410
Specialties & Taxonomies
Physician Assistant
Primary License: ID #PA-2158