Individual
TANNER WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2640 CHANNING WAY, IDAHO FALLS, ID 83404-7517
(208) 552-2248
Mailing address
2640 CHANNING WAY, IDAHO FALLS, ID 83404-7517
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-8048
ID
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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