NPI age
19 years
Enumerated 2007-01-08
Across 2006 active physical therapist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | T7382 | BLUE CROSS PROVIDER NUMBE |
| 05 (ID) | 806611601 | |
| 01 (ID) | 10142849 | BLUE SHIELD PROVIDER # |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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