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Individual

NELSON JAMIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
640 N EISENHOWER ST, MOSCOW, ID 83843-9588
(208) 882-6560
Mailing address
1215 S MOUNTAIN VIEW RD APT 102, MOSCOW, ID 83843-3283
(308) 214-0877

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1565
NE
225200000X
Physical Therapy Assistant
Primary
5400
ID

Other

Enumeration date
02/16/2017
Last updated
08/28/2021
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