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1407493638
ALISON R DEKERCHOVE
EAGLE, ID
NPI
1407493638
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-1837)
Enumeration Date
2019-12-06
Last Update Date
2023-11-08
Business Address
ALISON R DEKERCHOVE PA-C
3101 E STATE ST STE 1100
EAGLE, ID 83616-6232
Phone number: 208-473-3500
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Mailing Address
ALISON R DEKERCHOVE PA-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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