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Individual

DR. JONAH NICHOLAS HEYNEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
675 YELLOWSTONE AVE # 1, POCATELLO, ID 83201-4511
(208) 478-1488
Mailing address
486 PHEASANT RIDGE DR APT B, CHUBBUCK, ID 83202-1689
(208) 852-6538

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6967
ID
225100000X
Physical Therapist

Other

Enumeration date
07/10/2020
Last updated
07/10/2020
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