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1346367984
JACKIE J WHITESELL
BOISE, ID
NPI
1346367984
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2084N0400X Psychiatry & Neurology, Neurology
(Licence: ID M-11022)
Enumeration Date
2007-03-26
Last Update Date
2014-04-23
Business Address
Dr. JACKIE J WHITESELL MD
1072 N LIBERTY ST SUITE 303
BOISE, ID 83704-2800
Phone number: 208-367-2800
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Mailing Address
Dr. JACKIE J WHITESELL MD
3340 E GOLDSTONE WAY
MERIDIAN, ID 83642-1026
Phone number: 208-367-5170
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