Individual
JARED HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
512 POLE LINE RD STE 2, TWIN FALLS, ID 83301-6367
(208) 735-3636
(208) 735-3637
Mailing address
512 POLE LINE RD STE 2, TWIN FALLS, ID 83301-6367
(208) 740-4866
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-13901
ID
Other
Enumeration date
06/02/2016
Last updated
01/11/2024
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