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General NPI Number Information
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NPI Number | 1104928258
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Entity Type | Individual
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Provider Name | JEFFREY AARON BOX PT
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Gender | Male
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1435 S MAPLE GROVE SUITE 201
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City | BOISE
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State | ID
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Zip | 83709
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Country | US
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Telephone | 208-322-6200
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Fax | 208-322-6233
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Provider Business Mailing Address
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Address Line | PO BOX 711185
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City | SALT LAKE CITY
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State | UT
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Zip | 84171
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Country | US
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Telephone | 801-942-3311
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Fax | 801-942-5955
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT1980
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License Number State | ID
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