Individual
JAKOTA BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5402 W OVERLAND RD, BOISE, ID 83705-2640
(208) 629-1593
Mailing address
6452 N AGRARIAN LN APT B, MERIDIAN, ID 83646-1487
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-2368
ID
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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