Individual
MS. TERESA ANN DEBLIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
1618 S MILLENIUM WAY, SUITE 210, MERIDIAN, ID 33642
(208) 884-4647
(208) 884-8984
Mailing address
1673 W SHORELINE DR, SUITE 230, BOISE, ID 83702
(208) 343-4700
(208) 343-4706
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT915
ID
Other
Enumeration date
08/11/2006
Last updated
04/08/2008
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