NPI age
19 years
Enumerated 2006-08-12
Across 2006 active physical therapist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 804274300 | |
| 01 (ID) | 10026781 | BLUE SHIELD |
| 01 | TD780 | BLUE CROSS |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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