NPI age
20 years
Enumerated 2006-01-27
Across 2006 active physical therapist providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 8069260 | |
| 01 (ID) | T8802 | BLUE CROSS |
| 01 (ID) | 000010146459 | REGENCE BLUE SHIELD |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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