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Individual

MRS. ANGELA DAWN ANDRUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
2030 JENNIE LEE DR, SUITE A, IDAHO FALLS, ID 83404-7000
(208) 523-8879
(208) 523-0436
Mailing address
611 CEDAR RIDGE DR, IDAHO FALLS, ID 83404-7278
(208) 523-6052
(208) 523-0436

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1085
ID
2251P0200X
Pediatric Physical Therapist
PT1085
ID

Other

Enumeration date
05/30/2008
Last updated
05/30/2008
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