Organization
SLATE MEDICAL AESTHETICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY R MONROE DO (OWNER)
(208) 904-0217
Entity
Organization
Contact information
Practice address
920 DEON DR STE A, POCATELLO, ID 83201-3069
(208) 904-0217
Mailing address
920 DEON DR STE A, POCATELLO, ID 83201-3069
(208) 904-0217
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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