Individual
MARIE KLOSTERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
8382 N WAYNE DR STE 101, HAYDEN, ID 83835-6028
(208) 758-0484
Mailing address
8382 N WAYNE DR STE 101, HAYDEN, ID 83835-6028
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-5462
ID
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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