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Individual

MRS. JENNIFER ANN GOULD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
907 RYAN STREET, CHUBBUCK, ID 83202
(480) 823-2020
Mailing address
907 RYAN ST, CHUBBUCK, ID 83202-3027
(480) 823-2020

Taxonomy

Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
RHF69605
CA

Other

Enumeration date
03/28/2016
Last updated
03/28/2016
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