Individual
BEAU URBANIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7421 W VICTORY RD STE 103, BOISE, ID 83709-6764
(208) 514-3736
(208) 514-3672
Mailing address
7201 W CLEARWATER AVE STE B101, KENNEWICK, WA 99336-1694
(509) 544-0265
(509) 987-1614
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT8650
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT8650
STATE LICENSE
ID
Enumeration date
05/24/2023
Last updated
05/24/2023
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