Individual
JARROD STEPHEN ALTROGGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1626 S WELLS AVE STE 105, MERIDIAN, ID 83642-4528
(208) 789-0200
(208) 288-2784
Mailing address
3805 E COPPER POINT DR UNIT 0-103, MERIDIAN, ID 83642-7847
(406) 839-6988
(208) 288-2784
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-8292
ID
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT-8292
IDAHO DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSES
ID
Enumeration date
08/10/2022
Last updated
08/10/2022
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