JEREMY HANSEN

BOISE, ID
NPI1154665719
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: ID  PTA-341)
Enumeration Date2012-11-20
Last Update Date2012-11-20
Business Address
Mr. JEREMY HANSEN PTA
5959 N DISCOVERY WAY
BOISE, ID 83713-1556
Phone number: 208-378-0256
Mailing Address
Mr. JEREMY HANSEN PTA
5959 N DISCOVERY WAY
BOISE, ID 83713-1556
Phone number: 208-378-0256
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