Organization
ORTHOPAEDIC TRAUMA CONSULTANTS OF IDAHO
Active
Organization
ORTHOPAEDIC TRAUMA CONSULTANTS OF IDAHO
Active
Other names
North Fork Orthopedic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE DYLAN CHLEBECK MD (OWNER)
(208) 595-4440
Entity
Organization
Contact information
Practice address
875 S VANGUARD WAY STE 110, MERIDIAN, ID 83642-8541
(208) 595-4440
(855) 592-2514
Mailing address
875 S VANGUARD WAY STE 110, MERIDIAN, ID 83642-8541
(208) 595-4440
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
03/12/2024
Last updated
04/09/2024
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