NPI age
17 years
Enumerated 2008-06-09
Across 2006 active physical therapist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 808114400 | |
| 01 (ID) | 000010167780 | BLUE SHIELD |
| 01 (ID) | TD745 | BLUE CROSS |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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