CHARLES CODY OLIVER

BOISE, ID
NPI1689012049
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2251P0200X Physical Therapist, Pediatrics
(Licence: ID  PT-3307)
Enumeration Date2013-06-07
Last Update Date2013-06-07
Business Address
-- CHARLES CODY OLIVER PT, DPT
7211 W FRANKLIN RD
BOISE, ID 83709-0926
Phone number: 208-375-4200
Mailing Address
-- CHARLES CODY OLIVER PT, DPT
3161 S GLACIER BAY WAY
MERIDIAN, ID 83642-7824
Phone number: 208-871-3235
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