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Individual

JESSE BROUWER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
104 W 9TH AVE, POST FALLS, ID 83854-9216
(208) 777-9740
(208) 777-8316
Mailing address
PO BOX 3482, POST FALLS, ID 83877-3482
(208) 209-6170
(208) 209-6169

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-4056
ID

Other

Enumeration date
07/14/2015
Last updated
07/14/2015
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