Individual
JAY SMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3663 N LAKEHARBOR LN, BOISE, ID 83703-6913
(208) 522-6155
(208) 286-4292
Mailing address
3663 N LAKEHARBOR LN, BOISE, ID 83703-6913
(208) 522-6155
(208) 286-4292
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
ID
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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