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 Date2022-04-14
Business Address
DERRICK RAY JORGENSEN
3720 WOODKING DR
IDAHO FALLS, ID 83404
Phone number: 208-227-1100
Mailing Address
DERRICK RAY JORGENSEN
246 N CURLEW DR APT 7208
AMMON, ID 83401-1447
Phone number: 208-716-5614
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