Organization
SHELLMAN INC PA
Active
Organization
SHELLMAN INC PA
Active
Other names
North Idaho Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TESS ROGERS (OFFICE MANAGER)
(208) 664-8194
Entity
Organization
Contact information
Practice address
1917 N LAKEWOOD DR, COEUR D ALENE, ID 83814-2634
(208) 664-8194
(208) 667-1847
Mailing address
1917 N LAKEWOOD DR, COEUR D ALENE, ID 83814-2634
(208) 664-8194
(208) 667-1847
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
MULTIPLE PROVIDERS
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002778800
—
ID
01
—
0051780
GROUP PROVIDER NUMBER
WA
Enumeration date
08/12/2006
Last updated
03/06/2009
Update your record
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