Individual
JACQUIE ANNE ELCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BC- HIS
Contact information
Practice address
1084 N COLE RD, BOISE, ID 83704-8642
(208) 377-0019
(208) 377-0313
Mailing address
1084 N COLE RD, BOISE, ID 83704-8642
(208) 377-0019
(208) 377-0313
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA-187
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HA-187
IDAHO HEARING AID DEALER
ID
Enumeration date
03/17/2008
Last updated
07/31/2008
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