Individual
JEREMY A MAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
5520 N EAGLE RD, SUITE 102, BOISE, ID 83713-2700
(208) 938-5255
(208) 938-5545
Mailing address
2176 E FRANKLIN RD, SUITE 100, MERIDIAN, ID 83642-9024
(208) 288-1155
(208) 461-4510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2557
ID
Other
Enumeration date
07/22/2009
Last updated
09/14/2010
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