| NPI | 1497960983 |
|---|---|
| Doing Business As | DEBLIECK DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | JENNIFER DEBLIECK Physician Owner 208-939-5030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: ID M7045) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2007-07-17 |