Trent Jackman PT

NPI 1053503193 - Physical Therapist - 2251G0304X

NPI Details
NPI 1053503193
Gender Male
Enumeration Date 08/13/2007
Last Updated 08/13/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
GARRISON BLDG 63, ROOM 202
STOP 8045
POCATELLO ID, 83209-0001, US
Phone (208) 282-3065
Fax
Business Location
DEPT OF PHYSICAL THERAPY IDAHO STATE UNIVERSITY
STOP 8045
POCATELLO ID, 83209-0001, US
Phone (208) 282-3065
Fax
Toxanomy
Taxonomy Code 2251G0304X
License State Idaho
License Number PT-1236
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According to our database, Mr. Trent Jackman PT NPI is 1053503193, taxonomy code is 2251G0304X and license number is PT-1236, license state is located at Idaho. Trent Jackman PT physically located at Garrison Bldg 63, Room 202, Pocatello ID, 83209-0001. NPI Number Trent Jackman PT has the Individual type.

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1053503193 NPI number is provided on an as is basis without warranty of any kind. 1053503193 is maintained by the National Plan & Provider Enumeration System. The contents of Trent Jackman PT are for informational purposes only.