NPI age
19 years
Enumerated 2006-12-01
Across 2006 active physical therapist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 8079161 | |
| 01 (ID) | P00443133 | RETIRED RAILROAD MEDICARE |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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