Individual
JOSEPH THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMPO
Contact information
Practice address
801 BRYDEN AVE, LEWISTON, ID 83501-4927
(208) 798-4605
Mailing address
PO BOX 2620, HAYDEN, ID 83835-2620
(208) 676-9080
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010028073
REGENCE BLUE SHIELD OF ID
ID
01
—
135273
L&I
WA
01
—
8M820
BLUE CROSS OF IDAHO
ID
05
—
9047259
—
WA
Enumeration date
04/24/2007
Last updated
11/08/2007
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