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1053868430
ANTHONY CALVIN BOTOS
BOISE, ID
NPI
1053868430
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: ID PTA-363)
Enumeration Date
2016-09-02
Last Update Date
2016-09-02
Business Address
-- ANTHONY CALVIN BOTOS LPTA
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-1553
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Mailing Address
-- ANTHONY CALVIN BOTOS LPTA
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-1553
Copy
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