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Individual

DR. DANIEL JOHN BLIZZARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1641 E POLSTON AVE STE 101, POST FALLS, ID 83854-7852
(208) 457-4208
(208) 457-4197
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2300
(208) 262-2390

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
73555
GA
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
M-14130
ID
207XS0117X
Orthopaedic Surgery of the Spine Physician
MD60825859
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1871850727
ID
Enumeration date
04/17/2012
Last updated
01/28/2021
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