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Individual

MR. JASON T DALEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
600 ROBBINS ROAD, SUITE 401 INTERMOUNTAIN ORTHOPAEDICS, BOISE, ID 83702
(208) 383-0201
(208) 489-4300
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 383-0201
(208) 489-4300

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-861
ID
363AS0400X
Surgical Physician Assistant
PA-861
ID

Other

Enumeration date
12/15/2010
Last updated
04/04/2011
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