Individual
MS. SUSAN KATHLEEN BIRNBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
600 N ROBBINS RD, BOISE, ID 83702-4565
(208) 489-4640
Mailing address
4378 W QUAIL POINT CT, BOISE, ID 83703-3844
(208) 424-0324
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1533
ID
Other
Enumeration date
05/19/2012
Last updated
05/19/2012
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