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Kyle Dietrich, PA STUDENT
NPI 1932661352 · on the registry since 2019
Practice
- Address
- 921 S 8th Ave Stop 8253
Pocatello, ID 83209 - Phone
- (208) 282-4726
- Clinicians at this address
- 203
Registry record
- Primary taxonomy
- 390200000X
390200000X
- Also registered as
- 225700000X
- Licence states on file
- MT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-05-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho