Individual
JEREMY CHAD RINDLISBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
740 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(208) 542-9111
(208) 542-9114
Mailing address
740 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(208) 542-9111
(208) 542-9114
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1551
ID
363A00000X
Physician Assistant
PA60379809
WA
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
PA60379809
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83-3011825
STATE
ID
01
—
PA-1551
STATE
ID
01
—
PA873
STATE
WY
Enumeration date
06/14/2013
Last updated
08/12/2020
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