Bullard, Jody Alison Thatcher

Bullard, Jody Alison Thatcher is an individual health care provider with primary practice located at 2302 N Bogus Basin Rd Suite C, Boise ID 83702-0902. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Bullard, Jody Alison Thatcher can be contacted via phone (208) 344-0737.

Contact Information

Primary practice address
2302 N Bogus Basin Rd Suite C Boise ID 83702-0902
Phone: (208) 344-0737
Fax: (208) 344-0759
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT-1137 Idaho
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X PT-1137 Idaho

Profile Details

NPI number 1881759645
LBN Legal business name Bullard, Jody Alison Thatcher
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2006
Last updated Apr 25th, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881759645 NPPES
Idaho MEDICAID 807030700

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