Individual
JUSTIN HUNTSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
444 HOSPITAL WAY STE 801, POCATELLO, ID 83201-2792
(208) 232-6214
Mailing address
152 S 16TH PL, POCATELLO, ID 83201-4021
(208) 380-0207
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3931
ID
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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