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1275253643
JACOB VIAL
REXBURG, ID
NPI
1275253643
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-2557)
Enumeration Date
2022-08-29
Last Update Date
2023-09-12
Business Address
JACOB VIAL PA-C
525 S CENTER ST
REXBURG, ID 83460-0004
Phone number: 406-595-1515
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Mailing Address
JACOB VIAL PA-C
651 S 2400 W UNIT 11102
REXBURG, ID 83440-5484
Phone number: 406-595-1515
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