DEREK EDDIE

POCATELLO, ID
NPI1346375367
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: ID  PA-662)
Enumeration Date2007-02-22
Last Update Date2007-07-08
Business Address
-- DEREK EDDIE PA-C
560 MEMORIAL DR
POCATELLO, ID 83201-4073
Phone number: 208-234-1960
Mailing Address
-- DEREK EDDIE PA-C
560 MEMORIAL DR
POCATELLO, ID 83201-4073
Phone number: 208-234-1960
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