SearchIdaho104100000X

Jordan Ewing

NPI 1740095728 · on the registry since 2025 · sole proprietor

Practice

Address
940 South 5th West Unit 11307
Rexburg, ID 83440
Phone
(208) 701-8543

Registry record

Primary taxonomy
104100000X
104100000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2025-02-08

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