Individual
DAVE WALTER DICKINSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18293 PLUM RD, CALDWELL, ID 83607-8961
(801) 692-3208
Mailing address
18293 PLUM RD, CALDWELL, ID 83607-8961
(801) 692-3208
Taxonomy
Speciality
Code
Description
License number
State
163WH1000X
Hospice Registered Nurse
Primary
43731
ID
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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