Individual
KELCI DENAE MAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
7979 W RIFLEMAN ST, SUITE 100, BOISE, ID 83704-9066
(805) 571-1000
(888) 711-9067
Mailing address
7809 W WESLEY DR, BOISE, ID 83704-7253
(785) 424-4846
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3491
ID
Other
Enumeration date
07/15/2014
Last updated
09/16/2014
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