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1104394659
JESSICA ANNELAINE VANDYKE
BLACKFOOT, ID
NPI
1104394659
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-5957)
Enumeration Date
2018-11-02
Last Update Date
2022-09-16
Business Address
JESSICA ANNELAINE VANDYKE DPT
282 W BRIDGE ST
BLACKFOOT, ID 83221
Phone number: 208-684-0021
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Mailing Address
JESSICA ANNELAINE VANDYKE DPT
1800 FLANDRO DR STE 190
POCATELLO, ID 83202-4940
Phone number: 208-233-2248
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