Individual
MR. JEREMY DALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1618 S MILLENIUM WAY STE 100, MERIDIAN, ID 83642-6457
(208) 884-3376
(208) 884-0858
Mailing address
1411 FILLMORE ST, STE 600, TWIN FALLS, ID 83301-3343
(208) 933-4400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
TX
Other
Enumeration date
10/02/2013
Last updated
06/04/2025
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