Individual
JAMI J WHILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4400 E FLAMINGO AVE, NAMPA, ID 83687-9203
(208) 288-4970
(208) 463-3044
Mailing address
9652 W STATE ST, STAR, ID 83669-5858
(208) 286-0766
(208) 286-0768
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1206
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010150364
BLUE SHIELD
ID
05
—
807197100
—
ID
01
—
PC332
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
03/06/2020
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