person
Mr. Craig Stephen Kantack, PA-C
Medical Physician Assistant in Idaho Falls, Idaho
NPI 1699052357

Craig Stephen Kantack is a Medical Physician Assistant based in Idaho Falls, ID and is specialized in Medical. Craig Stephen Kantack practices in Idaho Falls, ID and has the professional credentials of PA-C. The NPI Number for Craig Stephen Kantack is 1699052357 and holds a License No. PA-984 (Idaho).

The current practice location address for Craig Stephen Kantack is 740 S Woodruff Ave, Idaho Falls, ID and can be reached out via phone at 208-542-9111.

Location: 740 S Woodruff Ave, Idaho Falls, ID, 83402-5842
person
Provider Profile Details
NPI Number
1699052357
Provider Name
Craig Stephen Kantack
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
740 S Woodruff Ave, Idaho Falls, ID, 83402-5842
Phone Number
208-542-9111
Fax Number
Provider Enumeration Date
11/09/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
740 S Woodruff Ave
City
State
Zip
83401-5285
Phone Number
208-542-9111
Fax Number
person
Provider Business Mailing Address Details
Address
740 S Woodruff Ave
City
State
Zip
83401-5285
Phone Number
208-542-9111
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA-984 (Idaho)
Definition
Definition to come...
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