Individual
MS. JANA NICOLE REPULSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, OCS
Contact information
Practice address
533 S RIVERSHORE LN, SUITE 120, EAGLE, ID 83616-4979
(208) 938-8020
(208) 938-8016
Mailing address
PO BOX 1328, EAGLE, ID 83616-1328
(208) 938-8020
(208) 938-8016
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1158
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807415500
—
ID
Enumeration date
05/12/2006
Last updated
02/08/2011
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