Individual
JONATHAN BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1130 ALLUMBAUGH ST, BOISE, ID 83704-8700
(208) 854-8500
Mailing address
898 N STRONGHOLD AVE, MERIDIAN, ID 83642-4693
(208) 895-6697
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2060
ID
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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