Individual
GAVIN MCEACHERN MORRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1101 N 28TH ST, BOISE, ID 83702-2208
(208) 336-1042
Mailing address
4725 SAMARA ST, BOISE, ID 83703-3642
(208) 336-1042
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1516
ID
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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