JACOB DANIEL SHIRLEY

POCATELLO, ID
NPI1992463970
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: ID  PA-2185)
Enumeration Date2021-12-07
Last Update Date2021-12-07
Business Address
JACOB DANIEL SHIRLEY PA
110 VISTA DR
POCATELLO, ID 83201-5824
Phone number: 208-234-2300
Mailing Address
JACOB DANIEL SHIRLEY PA
110 VISTA DR
POCATELLO, ID 83201-5824
Phone number: 208-234-2300
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