Individual
MATTHEW DAVID DETEMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1309 BENNETT AVE, BURLEY, ID 83318-2676
(208) 678-7796
(208) 678-7799
Mailing address
1309 BENNETT AVE, BURLEY, ID 83318-2676
(208) 678-7796
(208) 678-7799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-339
ID
Other
Enumeration date
04/27/2006
Last updated
11/05/2024
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