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Individual

MR. JEFFERY D. BALDWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
1224 8TH ST, SUITE A, RUPERT, ID 83350-1527
(208) 436-9016
(208) 436-4922
Mailing address
385 S HIGHWAY 27, BURLEY, ID 83318-5704
(208) 678-2405

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1466
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806879600
ID
Enumeration date
07/19/2006
Last updated
07/08/2007
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