Organization
JAN DEBLIECK MD PA
Active
Organization
JAN DEBLIECK MD PA
Active
Other names
DeBlieck Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER DEBLIECK M.D. (PHYSICIAN-OWNER)
(208) 939-5030
Entity
Organization
Contact information
Practice address
13176 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 939-5030
(208) 939-1892
Mailing address
13176 W PERSIMMON LN, BOISE, ID 83713-1986
(208) 939-5030
(208) 939-1892
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M7045
ID
Other
Enumeration date
05/10/2007
Last updated
07/17/2007
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