DERON J RICKS

IDAHO FALLS, ID
NPI1639156573
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA216)
Enumeration Date2005-12-30
Last Update Date2007-07-08
Business Address
-- DERON J RICKS PA
3100 CHANNING WAY STE 115
IDAHO FALLS, ID 83404-1647
Phone number: 208-535-4130
Mailing Address
-- DERON J RICKS PA
PO BOX 1647
IDAHO FALLS, ID 83404-1647
Phone number: 208-535-4130
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