Jacquelyn Rose Mallet, DPT

NPI #1962243063 in Spirit Lake, Idaho

Provider Information

NPI Number: 1962243063
Entity Type: Individual
Name: Jacquelyn Rose Mallet, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: Jun 3, 2024
Last Updated: Jun 3, 2024

Practice Location

Address: 6186 W MAINE ST
City: Spirit Lake
State: Idaho
ZIP Code: 83869-0149
Phone: (208) 449-1596

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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Organizations

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