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1336712124
LYDIA JACOBSON
BOISE, ID
NPI
1336712124
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-7376)
Enumeration Date
2021-07-20
Last Update Date
2021-07-20
Business Address
LYDIA JACOBSON DPT
717 N LIBERTY ST
BOISE, ID 83704-9342
Phone number: 208-367-8989
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Mailing Address
LYDIA JACOBSON DPT
4002 W PEAK CLOUD DR
MERIDIAN, ID 83642-5377
Phone number: 701-306-2946
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