Individual
JACOB WESTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3277 E LOUISE DR, MERIDIAN, ID 83642-9359
(208) 489-5800
Mailing address
7510 W PRINCE DR, BOISE, ID 83714-4338
(503) 396-0154
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3987
ID
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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