Individual
MR. JOHN BOYATT PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
726 E HAYDEN ST, POCATELLO, ID 83201-6226
(208) 317-3278
(208) 232-2295
Mailing address
726 E HAYDEN ST, POCATELLO, ID 83201-6226
(208) 317-3278
(208) 232-2295
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
POCATELLO BL3582
ID
Other
Enumeration date
09/27/2010
Last updated
09/27/2010
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