Individual
DR. DRAKE MATHEW HEITHOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
4623 ENTERPRISE WAY, CALDWELL, ID 83605-6764
(208) 455-4231
Mailing address
11057 W BRASSY COVE LOOP APT 201, NAMPA, ID 83651-5145
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7171077
ID
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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