Individual
MS. ERICA LANE BUNNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
10790 W OVERLAND RD, BOISE, ID 83709-1329
(208) 322-8709
(208) 322-8710
Mailing address
10790 W OVERLAND RD, BOISE, ID 83709-1329
(208) 322-8709
(208) 322-8710
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
DPT-2214
ID
Other
Enumeration date
08/10/2007
Last updated
08/10/2007
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