Individual
DR. JEREMIAH KIRTLAND YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
241 MAIN ST, GOODING, ID 83330-1103
(208) 934-4433
(208) 934-4639
Mailing address
531 CAYUSE CREEK DRIVE, KIMBERLY, ID 83341
(208) 736-1853
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1973
ID
Other
Enumeration date
05/30/2007
Last updated
12/08/2009
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