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Individual

ANTHONY TODD PEPPLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
457 S FITNESS PL, SUITE 100, EAGLE, ID 83616-6568
(208) 939-3332
(208) 939-3338
Mailing address
457 S FITNESS PL, STE 100, EAGLE, ID 83616-6568
(208) 939-3332
(208) 939-3338

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1520
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010028601
BLUE SHIELD
ID
01
11347663
FIRST HEALTH NETWORK
ID
05
806054500
ID
01
P00165209
STATE OF WA DEPT OF LABOR
ID
01
T4363
TRUE BLUE
ID
Enumeration date
08/20/2006
Last updated
02/04/2010
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