Individual
CORDELL PICKERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
526 FIRST AMERICAN CIR STE B, REXBURG, ID 83440-5400
(208) 534-7001
Mailing address
1940 S BONITO WAY STE 190, MERIDIAN, ID 83642-5618
(208) 287-9420
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5542
ID
Other
Enumeration date
07/02/2018
Last updated
03/01/2023
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