Individual
MRS. GLORIA GOULD GUNTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT, MED, PCS
Contact information
Practice address
113 E BULLION ST, SUITE C, HAILEY, ID 83333-8770
(208) 720-3421
(208) 297-2680
Mailing address
PO BOX 92, HAILEY, ID 83333-0092
(208) 720-3421
(208) 297-2680
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
RPT1204
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010030447
BLUE SHIELD OF IDAHO
—
05
—
1275512246
—
ID
01
—
T4868
BLUE CROSS OF IDAHO
—
Enumeration date
01/10/2006
Last updated
01/04/2017
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