NPI age
17 years
Enumerated 2008-07-23
Across 2006 active physical therapist providers in Idaho.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 808487601 | |
| 01 (ID) | P01610741 | RR MEDICARE |
| 05 (ID) | 1639334279-000 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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