Individual
NEY JIMMY DAVID RODRIGUEZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3021 SILVERFIELD WAY, POCATELLO, ID 83201-2780
(208) 240-0411
Mailing address
3021 SILVERFIELD WAY, POCATELLO, ID 83201-2780
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/08/2020
Last updated
02/08/2020
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