NPI age
19 years
Enumerated 2006-07-25
Across 2006 active physical therapist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | PT 1365 | IDAHO LICENSE |
| 05 (ID) | PENDING |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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