Individual
MR. STEVEN I JESSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A. LIC. ATC
Contact information
Practice address
980 W IRONWOOD DR, SUITE 207, COEUR D ALENE, ID 83814-2668
(208) 770-2971
(208) 770-2974
Mailing address
980 IRONWOOD DR., SUITE 207, COEUR D ALENE, ID 83814
(208) 770-2971
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-260
ID
Other
Enumeration date
02/06/2008
Last updated
06/18/2014
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