Individual
FRANK TODD DIMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT, LPTA
Contact information
Practice address
560 MEMORIAL DR, SUITE C, POCATELLO, ID 83201-4070
(208) 232-4267
(208) 232-4268
Mailing address
560 MEMORIAL DR, SUITE C, POCATELLO, ID 83201-4070
(208) 232-4267
(208) 232-4268
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-2676
ID
2255A2300X
Athletic Trainer
AT094
ID
Other
Enumeration date
06/29/2006
Last updated
07/07/2011
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