SearchIdaho225X00000X

Aj Jaques, OTRL

NPI 1659461168 · on the registry since 2006

Practice

Address
510 E 17th St # 400
Idaho Falls, ID 83404
Phone
(208) 589-0807
Fax
(208) 542-9577
Clinicians at this address
3

Registry record

Primary taxonomy
225X00000X
225X00000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2007-07-08

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