Individual
JONATHAN WILLIAM ROZACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
2775 CHANNING WAY, IDAHO FALLS, ID 83404-7510
(208) 524-0133
Mailing address
2775 CHANNING WAY, IDAHO FALLS, ID 83404-7510
(208) 524-0133
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP525A
ID
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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