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Individual

JONATHAN HOELZEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
1088 W PRAIRIE AVE, COEUR D ALENE, ID 83815-8741
(208) 772-6609
Mailing address
1450 NORTHWEST BLVD STE 106, COEUR D ALENE, ID 83814-5605
(208) 667-6264
(208) 664-4313

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-6196
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT-6196
BUREAU OF OCCUPATIONAL LICENSES
ID
Enumeration date
02/13/2019
Last updated
03/10/2020
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