Organization
KEYSTONE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD JENSEN FNP-C (PRESIDENT)
(208) 514-0670
Entity
Organization
Contact information
Practice address
1159 E IRON EAGLE DR, SUITE 170D, EAGLE, ID 83616-6871
(208) 514-0670
(208) 549-7880
Mailing address
1159 E IRON EAGLE DR, SUITE 170D, EAGLE, ID 83616-6871
(208) 514-0670
(208) 549-7880
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
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