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1588937130
JACOB L LAME
BOISE, ID
NPI
1588937130
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: ID PTA-370)
Enumeration Date
2012-02-13
Last Update Date
2012-02-13
Business Address
JACOB L LAME PTA
909 RESERVE ST.
BOISE, ID 83712
Phone number: 208-343-7717
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Mailing Address
JACOB L LAME PTA
4560 SE INTERNATIONAL WAY STE. 100
MILWAUKIE, OR 97222
Phone number: 971-206-5200
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