Individual
JENNIFER ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5900 N BROOK PL, GARDEN CITY, ID 83714-1724
(208) 608-9571
Mailing address
5900 N BROOK PL, GARDEN CITY, ID 83714-1724
(208) 608-9571
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3293
ID
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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