| Jacquelyn Rose Mallet, DPT | |
|
6186 W Maine St, Spirit Lake, ID 83869-0149 | |
| (208) 449-1596 | |
| Not Available |
| Full Name | Jacquelyn Rose Mallet |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 6186 W Maine St, Spirit Lake, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962243063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT-9060 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jacquelyn Rose Mallet, DPT 1917 N Lakewood Dr, Coeur D Alene, ID 83814-2634 Ph: (208) 763-0485 | Jacquelyn Rose Mallet, DPT 6186 W Maine St, Spirit Lake, ID 83869-0149 Ph: (208) 449-1596 |
Michael Victor Nowack, D.P.T Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6186 W Maine, Spirit Lake, ID 83869 Phone: 208-623-6717 | |
Adam Wheeler, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 31911 N 5th St, Spirit Lake, ID 83869 Phone: 208-623-6717 | |
Alpine Physical Therapy Center, P.c. Physical Therapist Medicare: Medicare Enrolled Practice Location: 31911 N 5th Ave, Spirit Lake, ID 83869 Phone: 208-623-6717 Fax: 208-623-4898 |