Individual
MS. INGRID A BURICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
305 E PARK ST, MCCALL, ID 83638-3827
(208) 634-3555
Mailing address
305 E PARK ST, MCCALL, ID 83638-3827
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT844
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010158289
REGENCE BLUE SHIELD
ID
01
—
TD518
BLUE CROSS
ID
Enumeration date
10/21/2006
Last updated
07/08/2007
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