PRESTON CHARLES MARTIN

BOISE, ID
NPI1912167230
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  PT-1824)
Enumeration Date2008-06-10
Last Update Date2008-06-10
Business Address
-- PRESTON CHARLES MARTIN MPT
1001 S HILTON ST
BOISE, ID 83705-1925
Phone number: 208-345-4464
Mailing Address
-- PRESTON CHARLES MARTIN MPT
5927 S TALLOWTREE WAY
BOISE, ID 83716-6965
Phone number: 208-859-1114
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