JACOB L LAME

BOISE, ID
NPI1588937130
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: ID  PTA-370)
Enumeration Date2012-02-13
Last Update Date2012-02-13
Business Address
-- JACOB L LAME PTA
909 RESERVE ST.
BOISE, ID 83712
Phone number: 208-343-7717
Mailing Address
-- JACOB L LAME PTA
4560 SE INTERNATIONAL WAY STE. 100
MILWAUKIE, OR 97222
Phone number: 971-206-5200
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