Individual
DANIELLE S JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
448 S MAPLE GROVE RD, BOISE, ID 83709
(208) 859-9953
(208) 629-3155
Mailing address
11337 VALLEY HEIGHTS CIR, BOISE, ID 83709-6645
(208) 562-0447
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT863
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010154466
BLUE SHIELD
ID
01
—
TD450
BLUE CROSS
ID
Enumeration date
12/14/2006
Last updated
07/08/2007
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