Jace Patrick Puckett
Jace Patrick Puckett is an Athletic Trainer in Moscow, Idaho. Practices as a sole proprietor. Registered with an NPI since 2018.
- In the registry since
- 2018
Practice location Address checks out
875 Perimeter DrMoscow, ID 83844-9803
Phone: (775) 351-8297
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Athletic Trainer (primary) | Taxonomy 2255A2300X |
|---|
Record details
| NPI number | 1982196291 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | June 1, 2018 |
| Last updated in NPPES | June 1, 2018 |
| Mailing address | 2306 White Ave Apt 203, Moscow, ID 83843-5099 |
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