Individual
MR. JAMES MICHAEL PEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1069 N SNEAD PL, EAGLE, ID 83616-6509
(208) 939-2715
Mailing address
1069 N SNEAD PL, EAGLE, ID 83616-6509
(208) 939-2715
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA71
ID
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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