Individual
MRS. DAVEE CARPENTER MUSSMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1224 8TH ST, SUITE A, RUPERT, ID 83350-1527
(208) 436-9016
Mailing address
3512 N 4500 E, MURTAUGH, ID 83344-5014
(208) 432-5644
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
633
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010021994
BLUE SHIELD
ID
01
—
T4108
BLUE CROSS
ID
Enumeration date
11/17/2005
Last updated
07/08/2007
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