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Organization

KOKKONEN P M AND R PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEREMY JUHANI KOKKONEN DO (OWNER)
(801) 473-2261
Entity
Organization

Contact information

Practice address
3372 E JENALAN, POST FALLS, ID 83854-7787
(801) 473-2261
Mailing address
2431 N HOWELL RD, POST FALLS, ID 83854-8201
(801) 473-2261

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
O-1190
MEDICAL LICENSE
ID
Enumeration date
09/19/2018
Last updated
04/14/2023
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