Individual
JORDAN V BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
360 E. LIBERTY, WEISER, ID 83672
(208) 414-1124
(208) 414-0947
Mailing address
645 E. 5TH ST, WEISER, ID 83672
(208) 414-1124
(208) 414-0947
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M12439
ID
Other
Enumeration date
04/04/2011
Last updated
02/16/2015
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