1598910937

Everything you always wanted to know about MRS. MCCOLLUM LEE JENNIFER MSPT but were afraid to ask.

MRS. MCCOLLUM LEE JENNIFER MSPT

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Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential
MRS. MCCOLLUM LEE JENNIFER MSPT
Gender:
Female
Enumeration date:
2008-11-26
Last update date:
2018-02-12
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
225100000X Physical Therapist ID PT-1935 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 2088142496
Practice Location Address Telephone Number 2088142496

Addresses

Type Address City State Postal Country
Mailing Address 801 POLE LINE RD W TWIN FALLS ID 83301 ID
Practice Location Address 801 POLE LINE RD W TWIN FALLS ID 83301 ID

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