Organization
ROOT & RENEW PRO-HEALTH SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BALLS OTR/L (OWNER)
(208) 244-5122
Entity
Organization
Contact information
Practice address
586 W 30 S, BLACKFOOT, ID 83221-6130
(208) 244-5122
Mailing address
586 W 30 S, BLACKFOOT, ID 83221-6130
(208) 244-5122
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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