Individual
JARED C PUGMIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT DPT
Contact information
Practice address
820 W CHUBBUCK RD, CHUBBUCK, ID 83202-2933
(208) 240-6017
(208) 240-6023
Mailing address
820 W CHUBBUCK RD, CHUBBUCK, ID 83202-2933
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5310
ID
225100000X
Physical Therapist
3018
NV
Other
Enumeration date
08/11/2014
Last updated
04/20/2020
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