Individual
JOSHUA ROBERT PEREGOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3315 8TH ST, LEWISTON, ID 83501-4966
(208) 746-9543
Mailing address
3315 8TH ST, LEWISTON, ID 83501-4966
(208) 746-9543
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-393
ID
Other
Enumeration date
06/16/2008
Last updated
06/16/2008
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