# DERMATOLOGY AND ALLERGIES CLINIC AT TETON VALLEY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871311647
- **Authorized official:** LYUDMYLA NORGART ARNP (BUSINESS OWNER)
- **Authorized official phone:** (813) 230-4241

## Contact information

- **Practice address:** 40 E LITTLE AVE, DRIGGS, ID 83422-5138
- **Practice address phone:** (208) 354-8220
- **Mailing address:** PO BOX 967, VICTOR, ID 83455-0967
- **Mailing address phone:** (813) 230-4241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/01/2024
- **Last updated:** 10/01/2024