Jacob Adam Lopez, | |
960 S Broadway Ave Ste 200, Boise, ID 83706-3667 | |
(208) 433-9211 | |
Not Available |
Full Name | Jacob Adam Lopez |
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Gender | Male |
Speciality | Physical Therapist |
Location | 960 S Broadway Ave Ste 200, Boise, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386349645 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Therapeutic Associates Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1487630240 PECOS PAC ID: 0042116279 Enrollment ID: O20040515000415 |
Mailing Address | Practice Location Address |
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Jacob Adam Lopez, 16083 Sw Upper Boones Ferry Rd Ste 300, Tigard, OR 97224-7736 Ph: () - | Jacob Adam Lopez, 960 S Broadway Ave Ste 200, Boise, ID 83706-3667 Ph: (208) 433-9211 |
Mrs. Dianne Denise Nelson, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1130 Allumbaugh St, Boise, ID 83704 Phone: 208-854-8517 | |
Peter H Kolb, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 901 N Curtis Rd Ste 204, Boise, ID 83706 Phone: 208-367-3315 Fax: 208-367-2674 | |
Melissa Pirtle, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 703 S Americana Blvd, Suite 130, Boise, ID 83702 Phone: 208-706-7530 Fax: 208-706-7531 | |
Kyle Aaron Holbrook, PT, DPT, NCS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 600 N Robbins Rd, Boise, ID 83702 Phone: 208-489-4444 | |
Rebecca Wensel, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2138 | |
Bridget Gilbertson, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2931 N Maywood Ave, Boise, ID 83704 Phone: 385-498-1740 | |
Idaho Physical Therapy Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1175 E Parkcenter Blvd, Ste 101, Boise, ID 83706 Phone: 208-367-1010 |