Individual
AMANDA BRADY KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
507 S MAIN ST, HAILEY, ID 83333-8428
(208) 788-0061
Mailing address
PO BOX 3727, KETCHUM, ID 83340-3727
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1651
ID
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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