DERRICK RAY JORGENSEN

IDAHO FALLS, ID
NPI1609519198
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-2250)
Enumeration Date2022-04-14
Last Update Date2026-01-28
Business Address
DERRICK RAY JORGENSEN
3200 CHANNING WAY STE 206
IDAHO FALLS, ID 83404-7546
Phone number: 208-529-2230
Mailing Address
DERRICK RAY JORGENSEN
3200 CHANNING WAY STE 206
IDAHO FALLS, ID 83404-7546
Phone number: 208-716-5614
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