NPI 1881072817

Jump Start Pediatrics

Organisation Supports Brokerage Agency Coeur D Alene, ID

Practice location

Address: 411 W Haycraft Ave STE D4, Coeur D Alene, ID 83815-8104
Phone: (206) 664-2468

Authorised official

Name: Becca Fahey
Title: Office Manager
Phone: (208) 664-2468

Registered specialties

Supports Brokerage Agency Primary

Agencies Taxonomy 251X00000X Licence OT-1455 (ID)

Other Supports Brokerage providers in Idaho →

Registry record

NPI: 1881072817
Entity type: Organization
NPI issued: 11 May 2015
Record last updated: 11 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.