Individual
JORDAN NEIL HALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1547 MIDWAY DR STE B, AMMON, ID 83406-6912
(208) 497-0429
(208) 497-0430
Mailing address
1547 MIDWAY DR STE B, AMMON, ID 83406-6912
(208) 497-0429
(208) 497-0430
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
53080
CA
Other
Enumeration date
12/04/2015
Last updated
05/27/2020
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