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1245870245
SAMUEL WAT TYLER
BOISE, ID
NPI
1245870245
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-6569)
Enumeration Date
2020-01-08
Last Update Date
2020-01-08
Business Address
-- SAMUEL WAT TYLER PT, DPT
703 S AMERICANA BLVD STE 130
BOISE, ID 83702-6754
Phone number: 208-706-7530
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Mailing Address
-- SAMUEL WAT TYLER PT, DPT
3016 S GEKELER LN
BOISE, ID 83706-5201
Phone number: 720-557-1636
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