Individual
MR. JAMES RICHARD TEATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4300 E FLAMINGO AVE, NAMPA, ID 83687-3138
(208) 205-5059
Mailing address
952 N CAMELOT DR, BOISE, ID 83704-8603
(503) 348-5132
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-4408
ID
Other
Enumeration date
04/12/2021
Last updated
04/12/2021
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