Search › Idaho › 2255A2300X
Jacob Casebolt, AT
NPI 1184162836 · on the registry since 2017
Practice
- Address
- 109 Taft Ave
Pocatello, ID 83201 - Phone
- (208) 705-5038
Additional practice sites
- 1307 E Broadway St., Missoula, MT
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Also registered as
- 390200000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-07-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho