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Jeremy Hansen, PTA

NPI 1154665719 · on the registry since 2012

Practice

Address
5959 N Discovery Way
Boise, ID 83713
Phone
(208) 378-0256
Fax
(208) 378-0269
Organisation at this address
Saint Alphonsus Regional Medical Center Inc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
225200000X
225200000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2012-11-20

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho