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Individual

SCOTT BILLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
703 AMERICANA BLVD, STE 130, BOISE, ID 83702
(208) 706-7530
(208) 706-7531
Mailing address
924 N YARMOUTH PL, EAGLE, ID 83616-5383
(208) 447-6950
(208) 706-7530

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT953
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT953
PT LISCENSE
ID
Enumeration date
12/02/2013
Last updated
12/02/2013
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