AUTUMN GROVE

HAYDEN, ID
NPI1033596747
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  PT-5390)
Additional Taxonomies2251X0800X Physical Therapist, Orthopedic
(Licence: CO  PTL. 0013479)
Enumeration Date2015-05-01
Last Update Date2024-08-01
Business Address
AUTUMN GROVE
8238 N GOVERNMENT WAY
HAYDEN, ID 83835-5034
Phone number: 208-762-2100
Mailing Address
AUTUMN GROVE
8238 N GOVERNMENT WAY
HAYDEN, ID 83835-5034
Phone number: 208-762-2100