Individual
MR. JERRET K HOPSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1673 W SHORELINE DR, SUITE 230, BOISE, ID 83702
(208) 343-4700
(208) 343-4706
Mailing address
1673 W SHORELINE DR, SUITE 230, BOISE, ID 83702
(208) 343-4700
(208) 343-4706
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1315
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT1315
STATE LIC
—
Enumeration date
08/01/2006
Last updated
04/08/2008
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