Individual
BRENDA KAY JERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
30544 HIGHWAY 200 STE 326, PONDERAY, ID 83852-5042
(208) 205-9559
Mailing address
1917 N LAKEWOOD DR, COEUR D ALENE, ID 83814-2634
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2889
ID
Other
Enumeration date
08/23/2011
Last updated
05/04/2026
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