Individual
CHASE RICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3080 E GENTRY WAY STE 210, MERIDIAN, ID 83642-3013
(208) 384-9022
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M-16662
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
IN
Other
Enumeration date
04/01/2019
Last updated
05/26/2022
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