Individual
MR. DALE DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
115 FALLS AVE W, TWIN FALLS, ID 83301-3115
(208) 733-1662
Mailing address
PO BOX 3245, IDAHO FALLS, ID 83403-3245
(208) 525-2090
(208) 525-2662
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
N-17941
ID
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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