Individual
TRISTEN JERRY LOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 CITY ST, NEWDALE, ID 83436-7716
(208) 360-0193
Mailing address
PO BOX 93, NEWDALE, ID 83436-0093
(208) 360-0193
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
230368
ID
Other
Enumeration date
08/06/2026
Last updated
08/06/2026
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