Idaho Falls Dermatology P A
Idaho Falls Dermatology P A is a Specialist in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2007.
- Licensed in
- ID
- In the registry since
- 2007
Practice location Address checks out
2001 S Woodruff Ave Ste 12AIdaho Falls, ID 83404-6374
Phone: (208) 522-8945
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Specialist (primary) | Taxonomy 174400000X · Licence 5809M (ID) |
|---|
Record details
| NPI number | 1487700464 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Cornelius Brooke — M.D. · (208) 522-8945 |
| NPI enumerated | January 25, 2007 |
| Last updated in NPPES | July 5, 2016 |
| Mailing address | 2001 S Woodruff Ave, Ste 12a, Idaho Falls, ID 83404-6374 |
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