Individual
MICHAEL WADE SCHOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1450 EAST FAIRVIEW AVENUE, #201, MERIDIAN, ID 83642
(208) 887-6757
(208) 887-6551
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171
(801) 942-3311
(801) 942-5955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
RPT510
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0027023000
—
ID
Enumeration date
09/07/2006
Last updated
07/08/2007
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