Individual
TRISTAN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3360 S 15TH E, IDAHO FALLS, ID 83404-8321
(208) 552-6200
Mailing address
3261 N 3250 W, MOORE, ID 83255-8729
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3955
ID
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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