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Individual

RYAN JAMES DELGATTI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
775 POLE LINE RD W STE 212, TWIN FALLS, ID 83301-5820
(208) 814-8400
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241

Taxonomy

Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
O-1829
ID
390200000X
Student in an Organized Health Care Education/Training Program
RTL
NC

Other

Enumeration date
07/10/2017
Last updated
07/20/2023
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