Graduated: 2018
NPI: 1225518509
Practice Locations (2)
IDAHO SKIN INSTITUTE LLC
147 W CHUBBUCK RD
CHUBBUCK, ID 832022314
2082387546
IDAHO SKIN INSTITUTE LLC
1411 FALLS AVE E, SUITE 1002
TWIN FALLS, ID 833013459
2085955424
Source: CMS National Downloadable File, September 2026.