NPI age
19 years
Enumerated 2007-04-24
Across 9 active prosthetist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | 135273 | L&I |
| 01 (ID) | 8M820 | BLUE CROSS OF IDAHO |
| 01 (ID) | 000010028073 | REGENCE BLUE SHIELD OF ID |
| 05 (WA) | 9047259 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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