Individual
JACOB OAKLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
224 E MAIN ST, BURLEY, ID 83318
(208) 647-0184
Mailing address
254 RIVER VISTA PL, TWIN FALLS, ID 83301-3006
(208) 734-7333
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-4243
ID
Other
Enumeration date
05/11/2022
Last updated
06/08/2022
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