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Individual

DEBORA CAIRES NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
2200 IRONWOOD PL, COEUR D ALENE, ID 83814-2610
(208) 667-6486
(208) 676-8276
Mailing address
2200 IRONWOOD PL, COEUR D ALENE, ID 83814-2610
(208) 667-6486
(208) 676-8276

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1343
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010138360
BLUE SHIELD
ID
01
0161551
LABOR AND INDUSTRY
WA
05
806161000
ID
01
T5410
BLUE CROSS
ID
Enumeration date
06/26/2006
Last updated
10/21/2013
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