NPI age
19 years
Enumerated 2006-10-06
Across 2006 active physical therapist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 | TC977 | BLUE CROSS |
| 01 | 000010150739 | BLUE SHIELD |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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