Individual
JARED PRINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
7599 W DEERFAWN LN, EAGLE, ID 83616-5616
(208) 570-5200
Mailing address
7599 W DEERFAWN LN, EAGLE, ID 83616-5616
(208) 570-5200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-8967
ID
Other
Enumeration date
08/01/2006
Last updated
02/15/2024
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