Individual
JASON W BALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
586 W 30 S, BLACKFOOT, ID 83221-6130
(208) 244-5122
Mailing address
586 W 30 S, BLACKFOOT, ID 83221-6130
(208) 244-5122
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1903
ID
Other
Enumeration date
04/23/2014
Last updated
02/10/2025
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