NPI age
20 years
Enumerated 2005-08-04
Across 2006 active physical therapist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010025680 | BLUE SHIELD PIN |
| 01 (ID) | T4884 | BLUE CROSS PIN |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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