RICHARD DALE BLICKENSTAFF

BOISE, ID
NPI1265514582
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207NS0135X Dermatology, Procedural Dermatology
(Licence: ID  M-5274)
Enumeration Date2006-10-19
Last Update Date2007-11-29
Business Address
Dr. RICHARD DALE BLICKENSTAFF M.D.
6454 W EMERALD STREET
BOISE, ID 83704-8734
Phone number: 208-377-0820
Mailing Address
Dr. RICHARD DALE BLICKENSTAFF M.D.
6454 W EMERALD STREET
BOISE, ID 83704-8734
Phone number:
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