Individual
JADELYN TAYLOR EISELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 RAILROAD ST APT 4, MOSCOW, ID 83843-2381
(208) 392-7081
Mailing address
707 RAILROAD ST APT 4, MOSCOW, ID 83843-2381
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/04/2020
Last updated
07/04/2020
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