NPI 1306698071

Jeremy Shupperd, CPO

Practitioner Prosthetist Boise, ID

Practice location

Address: 427 N Curtis Rd, Boise, ID 83706-1439
Phone: (208) 342-4104
Fax: (208) 342-4106

Registered specialties (2)

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

Other Prosthetist providers in Idaho →

Orthotist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X

Other Orthotist providers in Idaho →

Registry record

NPI: 1306698071
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Apr 2024
Record last updated: 4 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.