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1346375367
DEREK EDDIE
POCATELLO, ID
NPI
1346375367
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant Medical
(Licence: ID PA-662)
Enumeration Date
2007-02-22
Last Update Date
2007-07-08
Business Address
DEREK EDDIE PA-C
560 MEMORIAL DR
POCATELLO, ID 83201-4073
Phone number: 208-234-1960
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Mailing Address
DEREK EDDIE PA-C
560 MEMORIAL DR
POCATELLO, ID 83201-4073
Phone number: 208-234-1960
Copy
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