Individual
MR. BRANDON SCOTT HAWKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
285 W FRANCIS ST, BLACKFOOT, ID 83221-1751
(208) 785-0123
(208) 782-1885
Mailing address
285 W FRANCIS ST, BLACKFOOT, ID 83221-1751
(208) 785-0123
(208) 782-1885
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2977
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805694300
—
ID
01
—
T9453
BLUE CROSS
ID
Enumeration date
05/15/2012
Last updated
05/15/2012
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