Individual
MRS. JACQUELYN CHARTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2015 S ORCHARD ST, BOISE, ID 83705-3639
(816) 806-7151
Mailing address
5347 S PALATINO AVE, MERIDIAN, ID 83642-4461
(816) 806-7151
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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