Individual
JASON JOHN OVEROCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 381-7370
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(706) 447-7184
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-1466
ID
Other
Enumeration date
10/27/2015
Last updated
03/14/2023
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