Individual
TYSON JADE FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7711 W RIVERSIDE DR, BOISE, ID 83714-6254
(208) 813-9544
(208) 810-4499
Mailing address
7711 W RIVERSIDE DR, BOISE, ID 83714-6254
(208) 813-9544
(208) 810-4499
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8971055
ID
Other
Enumeration date
10/18/2024
Last updated
05/23/2025
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