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1730542143
JOSHUA TED HANSEN
JEROME, ID
NPI
1730542143
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: ID O-1656)
Enumeration Date
2016-04-02
Last Update Date
2022-06-13
Business Address
JOSHUA TED HANSEN D.O.
132 5TH AVE W
JEROME, ID 83338-1825
Phone number: 208-814-9800
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Mailing Address
JOSHUA TED HANSEN D.O.
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number:
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