Mr. Trent Jackman
Physical Therapist - Geriatrics
Garrison Bldg 63, Room 202 Stop 8045
Pocatello
, Idaho 83209-0001
Mr. Trent Jackman
Physical Therapist - Geriatrics
Garrison Bldg 63, Room 202 Stop 8045
Pocatello
, Idaho 83209-0001
(208) 282-3065
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About
Features
Specialties
- Physical Therapist - Geriatrics
Languages spoken
- English
Location
First Address
- Mr. Trent Jackman
- Dept Of Physical Therapy Idaho State University Stop 8045
- Pocatello, ID
- Zip : 83209-0001
- Phone : (208) 282-3065
Second Address
- Mr. Trent Jackman
- Garrison Bldg 63, Room 202 Stop 8045
- Pocatello, ID
- Zip : 83209-0001
- Phone : (208) 282-3065
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251G0304X | Physical Therapist - Geriatrics | PT-1236 | ID |
National Provider Identifier
| NPI | 1053503193 |
|---|---|
| Provider Name | Mr. Trent Jackman |
| First Address | Pocatello, ID 83209-0001 |
| Second Address | Pocatello, ID 83209-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/08/2007 |
| Last Update Date | 13/08/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.