Demond, Jeffrey Bowen
Demond, Jeffrey Bowen is an individual health care provider with primary practice located at 2321 E Gala St Suite 1, Meridian ID 83642-4881. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Demond, Jeffrey Bowen can be contacted via phone (208) 888-4321.Contact Information
Primary practice address
2321 E Gala St Suite 1
Meridian ID 83642-4881
Phone: (208) 888-4321
Fax: (208) 895-8747
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT-1640 | Idaho |
Profile Details
| NPI number | 1134165590 |
|---|---|
| LBN Legal business name | Demond, Jeffrey Bowen |
| Credentials | MPT, CLT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134165590 | NPPES |
| Idaho | Other | 000010154278 | REGENCE BLUE SHIELD ID |
| Idaho | Other | 11571122 | REGENCE BLUE SHIELD ID |
| Idaho | Other | TD264 | REGENCE BLUE SHIELD ID |
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