NPI 1063184554
Jonas Dethman
Practice location
- Address
- 239 Winged Foot Pl, Eagle, ID 83616-5265
- Phone
- (208) 473-0493
Registered specialties
Home Health Aide
Primary
Registry record
- NPI
- 1063184554
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 2 Oct 2021
- Record last updated
- 2 Oct 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.