NPI age
19 years
Enumerated 2006-07-14
Across 2006 active physical therapist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 806834400 | |
| 01 (ID) | TD767 | BLUE CROSS OF ID |
| 01 (ID) | 000010138628 | REGENCE BLUE SHIELD OF ID |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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