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Individual

KATHY A DUFUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT ATC

Contact information

Practice address
4400 E FLAMINGO AVE, NAMPA, ID 83687-9203
(208) 288-4970
(208) 463-3044
Mailing address
217 W GEORGIA AVE, STE 115, NAMPA, ID 83686-6811
(208) 463-3234
(208) 463-3044

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1564
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010150173
BLUE SHIELD
ID
05
807199600
ID
01
P00217064
RAILROAD MEDICARE
ID
01
TC308
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
02/09/2010
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