Jason Detwiler
Jason Detwiler is a Physical Therapy Assistant in Boise, Idaho. Practices as a sole proprietor. Licensed in New Jersey.
- Licensed in
- NJ
- In the registry since
- 2019
Practice location Address checks out
2411 S Essex WayBoise, ID 83709-2304
Phone: (208) 353-0976
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physical Therapy Assistant (primary) | Taxonomy 225200000X · Licence 40QB00360700 (NJ) |
|---|
Record details
| NPI number | 1275197667 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | May 1, 2019 |
| Last updated in NPPES | May 1, 2019 |
| Mailing address | 2411 S Essex Way, Boise, ID 83709-2304 |
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