Individual
MR. DALE C WHEELWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
7 N 600 W, BLACKFOOT, ID 83221-5533
(208) 782-2267
(208) 684-9812
Mailing address
7 N 600 W, BLACKFOOT, ID 83221-5533
(208) 782-2267
(208) 684-9812
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
RPT-1406
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010140771
NDPT REGENCE BS OF ID
ID
01
—
5586533
NDPT CCN
ID
05
—
806464000
—
ID
01
—
T6947
NDPT BLUE CROSS OF ID
ID
Enumeration date
04/07/2006
Last updated
04/01/2014
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