Individual
CHRISTOPHER D GAMMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
600 N ROBBINS RD, STE 100, BOISE, ID 83702-4566
(208) 383-0201
(208) 489-4249
Mailing address
600 N ROBBINS RD, STE 401, BOISE, ID 83702-4566
(208) 383-0201
(208) 489-4249
Taxonomy
Speciality
Code
Description
License number
State
2251H1200X
Hand Physical Therapist
Primary
OT-657
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1655913
HUMANA
ID
01
—
P00181938
MEDICARE RAILROAD
ID
01
—
W0988
BLUE CROSS OF IDAHO
ID
Enumeration date
08/13/2006
Last updated
02/05/2008
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