Individual
JENNIFER KATHERINE FAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1110 CALL CREEK DR STE 7, POCATELLO, ID 83201-3072
(208) 233-4660
(208) 233-4262
Mailing address
4170 HAWTHORNE RD, CHUBBUCK, ID 83202-2707
(701) 426-3444
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17525
NC
Other
Enumeration date
10/27/2017
Last updated
09/22/2021
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