Jeffrey Nielsen II, DPT

Individual provider Active NPI Physical Therapist · Malad City, ID

NPI 1225836588 · NPPES record last updated Aug 24, 2026

Key facts

NPI
1225836588
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
8136 (ID)
Practice address
554 S 5400 W
Malad City, ID 83252-6556
Phone
(801) 935-0127
NPI assigned
Mar 4, 2025
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8136IDMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8136 ID Yes

Addresses

Primary practice location

554 S 5400 W
Malad City, ID 83252-6556

Mailing address

45 N 2ND E
Preston, ID 83263-1334
Phone (801) 935-0127

Other providers in Malad City, ID

All providers in Malad City, ID · Physical Therapist in Idaho

Sources for this page

Verify at the official NPI Registry.