Organization
ANDREASEN PHYSICAL THERAPY PC
Active
Organization
ANDREASEN PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DIRK ANDREASEN PT (PRESIDENT)
(208) 201-0877
Entity
Organization
Contact information
Practice address
1808 N 2190 E, SUGAR CITY, ID 83448-1310
(208) 201-0877
Mailing address
1808 N 2190 E, SUGAR CITY, ID 83448-1310
(208) 201-0877
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-737
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
327268
BLUE SHIELD NUMBER
ID
01
—
T3761
BLUE CROSS NUMBER
ID
Enumeration date
01/18/2007
Last updated
08/22/2020
Update your record
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