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Organization
ALPINE DERMATOLOGY CLINIC P.C.
Active
Organization
ALPINE DERMATOLOGY CLINIC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL R MARSHALL D.O. (OWNER, CEO)
(208) 359-4841
Entity
Organization
Contact information
Practice address
1049 SUMMERS DR, REXBURG, ID 83440-5335
(208) 359-4841
Mailing address
1049 SUMMERS DR, REXBURG, ID 83440-5335
(208) 359-4841
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
O-0508
ID
Other
Enumeration date
02/02/2009
Last updated
04/05/2019
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