Individual
CHARLES WILLIAM JENKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1246 YELLOWSTONE AVE STE C5, POCATELLO, ID 83201-4373
(208) 233-0150
(208) 233-0159
Mailing address
1246 YELLOWSTONE AVE STE C5, POCATELLO, ID 83201-4373
(208) 233-0150
(208) 233-0159
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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