Individual
BART SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2200 IRONWOOD PL, COEUR D ALENE, ID 83814-2610
(208) 667-6486
Mailing address
2200 IRONWOOD PL, COEUR D ALENE, ID 83814-2610
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1487
OR
225100000X
Physical Therapist
Primary
PT-3306
ID
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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