NPI age
14 years
Enumerated 2012-05-15
Across 2006 active physical therapist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 805694300 | |
| 01 (ID) | T9453 | BLUE CROSS |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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