NPI age
19 years
Enumerated 2007-02-27
Across 2006 active physical therapist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010152747 | BLUE SHIELD |
| 01 (ID) | TD256 | BLUECROSS# IN GROUP 8M558 |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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