Individual
JODY BRAMELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2870 JUNIPER DR, LEWISTON, ID 83501-4720
(208) 746-2800
Mailing address
2870 JUNIPER DR, LEWISTON, ID 83501-4720
(208) 746-2800
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
P1 60047585
WA
225200000X
Physical Therapy Assistant
Primary
PTA-2465
ID
Other
Enumeration date
09/05/2014
Last updated
09/05/2014
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