Individual
JACE EYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1351 W PINE AVE, MERIDIAN, ID 83642-5031
(208) 888-7049
Mailing address
1351 W PINE AVE, MERIDIAN, ID 83642-5031
(208) 888-7049
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4188
ID
Other
Enumeration date
08/25/2015
Last updated
08/25/2015
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