Individual
JESSICA PACKER SMOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3820 CRESTWOOD LN, IDAHO FALLS, ID 83404-4979
(208) 552-7700
Mailing address
1138 MONAGHAN CT, IDAHO FALLS, ID 83404-8309
(208) 313-6033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1861669
ID
Other
Enumeration date
05/04/2024
Last updated
07/17/2024
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