Gronholz-Dero, M Jill
Gronholz-Dero, M Jill is an individual health care provider with primary practice located at 914 W Ironwood Dr , Coeur D Alene ID 83814-4927. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Gronholz-Dero, M Jill can be contacted via phone (208) 765-5922.Contact Information
Primary practice address
914 W Ironwood Dr
Coeur D Alene ID 83814-4927
Phone: (208) 765-5922
Fax: (208) 664-3169
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0-45 | Idaho |
Profile Details
| NPI number | 1093700593 |
|---|---|
| LBN Legal business name | Gronholz-Dero, M Jill |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 12th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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