JACOB MATTHEW PETTIT

BLACKFOOT, ID
NPI1437888062
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2251X0800X Physical Therapist, Orthopedic
(Licence: ID  PT-8007)
Enumeration Date2022-06-08
Last Update Date2022-06-08
Business Address
-- JACOB MATTHEW PETTIT DPT
1250 W BRIDGE ST
BLACKFOOT, ID 83221-5095
Phone number: 208-785-8018
Mailing Address
-- JACOB MATTHEW PETTIT DPT
313 PARK AVE
POCATELLO, ID 83201-4506
Phone number:
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