JACE PATRICK PUCKETT

MOSCOW, ID
NPI1982196291
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date2018-06-01
Last Update Date2018-06-01
Business Address
JACE PATRICK PUCKETT
875 PERIMETER DR
MOSCOW, ID 83844-9803
Phone number: 775-351-8297
Mailing Address
JACE PATRICK PUCKETT
2306 WHITE AVE APT 203
MOSCOW, ID 83843-5099
Phone number: 775-351-8297
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