Provider Demographics
NPI:1033415187
Name:KAUFMANN, JOSHUA ALLEN (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALLEN
Last Name:KAUFMANN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ENTERPRISE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:BONNERS FERRY
Mailing Address - State:ID
Mailing Address - Zip Code:83805-6266
Mailing Address - Country:US
Mailing Address - Phone:208-597-7250
Mailing Address - Fax:208-550-3752
Practice Address - Street 1:33 ENTERPRISE DR STE 101
Practice Address - Street 2:
Practice Address - City:BONNERS FERRY
Practice Address - State:ID
Practice Address - Zip Code:83805-6266
Practice Address - Country:US
Practice Address - Phone:208-597-7250
Practice Address - Fax:208-550-3752
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-2895225100000X
MI5501015471225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501015471OtherMICHIGAN LICENSE