Search › Idaho › 101YA0400X
Kevin Pettus, CCS, ACADC
NPI 1265848717 · on the registry since 2014 · sole proprietor
Practice
- Address
- 25431 Hwy 93
Challis, Idaho 83226, ID 83226 - Phone
- (208) 879-2267
Additional practice sites
- 605 11th Ave E, Gooding, ID
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Also registered as
- 101YA0400X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-09-03
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