Individual
CASONDRA DAWN PAHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
620 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5299
(208) 419-3408
Mailing address
620 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5299
(208) 419-3408
(208) 529-3336
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-4045
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT-4045
IDAHO STATE LICENSE
ID
Enumeration date
06/04/2015
Last updated
04/05/2021
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