Individual
MYKAELA MAE ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
2884 N PENNY ROYAL PL, BOISE, ID 83713-1135
(208) 908-3802
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-6669
ID
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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