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Jonas Dethman
NPI 1063184554 · on the registry since 2021 · sole proprietor
Practice
- Address
- 239 Winged Foot Pl
Eagle, ID 83616 - Phone
- (208) 473-0493
Registry record
- Primary taxonomy
- 374U00000X
374U00000X
- Sex
- Male
- Record last updated
- 2021-10-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho