NPI age
16 years
Enumerated 2010-05-10
Across 2006 active physical therapist providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | PT-3463 | OCCUPATIONAL LICENSE |
Part of a multi-provider practice. 13 other active providers share this practice address in NPPES.
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