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1962547257
RANDY C SIDWELL
POCATELLO, ID
NPI
1962547257
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-1535)
Enumeration Date
2007-02-21
Last Update Date
2012-03-15
Business Address
Mr. RANDY C SIDWELL PT, MS, ATC
333 N 18TH AVE STE D2
POCATELLO, ID 83201-3358
Phone number: 208-232-6490
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Mailing Address
Mr. RANDY C SIDWELL PT, MS, ATC
333 N 18TH AVE STE D2
POCATELLO, ID 83201-3358
Phone number: 208-232-6490
Copy
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