Individual
MRS. JENNIFER LYNN NEVALA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
50 E JAMES COURT, SUITE A, MERIDIAN, ID 83642
(208) 895-0715
(208) 895-0746
Mailing address
50 E JAMES COURT, SUITE A, MERIDIAN, ID 83642
(208) 895-0715
(208) 895-0746
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1430
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806804600
—
ID
Enumeration date
03/07/2006
Last updated
07/08/2007
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