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1982905972
JASON DERIC LEBEL
POCATELLO, ID
NPI
1982905972
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-2439)
Enumeration Date
2010-11-08
Last Update Date
2010-11-08
Business Address
-- JASON DERIC LEBEL PT
4650 HAWTHORNE RD SUITE 2B
POCATELLO, ID 83202-2376
Phone number: 208-221-6952
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Mailing Address
-- JASON DERIC LEBEL PT
9417 N CONNELL RD
POCATELLO, ID 83201-9057
Phone number: 208-406-7975
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