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1518631738
JONATHAN BRUBAKER
BOISE, ID
NPI
1518631738
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-7324)
Enumeration Date
2021-08-02
Last Update Date
2021-11-10
Business Address
JONATHAN BRUBAKER
1003 N ORCHARD ST
BOISE, ID 83706-2231
Phone number: 208-376-3113
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Mailing Address
JONATHAN BRUBAKER
1750 S LINDER RD UNIT E202
MERIDIAN, ID 83642-7396
Phone number:
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