Individual
TYCE ALDEN STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
285 W FRANCIS ST, BLACKFOOT, ID 83221-1751
(208) 785-0123
(208) 782-1885
Mailing address
285 W FRANCIS ST, BLACKFOOT, ID 83221-1751
(208) 785-0123
(208) 782-1885
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-6224
ID
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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