Individual
JAYLAN ISAIAH HIBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4776 N FIVE MILE RD STE 101, BOISE, ID 83713-2715
(208) 658-9500
(208) 658-9501
Mailing address
4776 N FIVE MILE RD STE 101, BOISE, ID 83713-2715
(208) 658-9500
(208) 658-9501
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
8544
ID
Other
Enumeration date
06/14/2023
Last updated
06/15/2023
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