JACOB SHANE TEBBS

BOISE, ID
NPI1154870251
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: UT  10103875-1206)
Enumeration Date2016-09-29
Last Update Date2020-08-07
Business Address
JACOB SHANE TEBBS PA-C
6051 N EAGLE RD
BOISE, ID 83713-0997
Phone number: 208-519-4333
Mailing Address
JACOB SHANE TEBBS PA-C
1900 N STATE ST
PROVO, UT 84604-1305
Phone number: 801-373-2001
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