Individual
JEREMY DANIEL FRIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1648 NW 1ST STREET, MERIDIAN, ID 83642
(208) 888-9393
(208) 888-9525
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6522
(208) 955-6503
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-552
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807240800
—
ID
Enumeration date
06/29/2006
Last updated
02/20/2017
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