Individual
JONATHAN GARDUNIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
13900 W WAINWRIGHT DR, BOISE, ID 83713-5028
(208) 351-9955
Mailing address
13900 W WAINWRIGHT DR, BOISE, ID 83713-5028
(208) 351-9955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
60688
OR
225100000X
Physical Therapist
Primary
PT-2549
ID
Other
Enumeration date
06/16/2009
Last updated
11/20/2014
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