Individual
SARAH INGALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4425 BURLEY DR, CHUBBUCK, ID 83202-1957
(208) 637-1100
Mailing address
1349 E BRIDGER ST, POCATELLO, ID 83201-4739
(909) 519-6918
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
8555982-2401
UT
225100000X
Physical Therapist
Primary
PT-3289
ID
Other
Enumeration date
10/30/2013
Last updated
10/30/2013
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