Individual
JASON MARKETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2870 JUNIPER DR, LEWISTON, ID 83501-4720
(208) 746-2800
Mailing address
PO BOX 273, LEWISTON, ID 83501-0273
(208) 745-3231
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-2122
ID
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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