SKY BLUE THACKER

BOISE, ID
NPI1134580616
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  PT-1909)
Enumeration Date2016-03-11
Last Update Date2026-05-20
Business Address
SKY BLUE THACKER P.T.
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 435-881-1125
Mailing Address
SKY BLUE THACKER P.T.
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 435-881-1125