Individual
CARLIE M LAUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
13895 W WAINWRIGHT DR, BOISE, ID 83713-5011
(208) 939-0533
(208) 939-3341
Mailing address
12072 MCMILLAN RD, BOISE, ID 83713-2462
(208) 939-0533
(208) 939-3341
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2545
ID
Other
Enumeration date
07/27/2009
Last updated
12/10/2012
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