Individual
REUBEN LIKA WOOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4776 N FIVE MILE RD STE 101, BOISE, ID 83713-2715
(208) 658-9500
(208) 658-9501
Mailing address
4776 N FIVE MILE RD STE 101, BOISE, ID 83713-2715
(208) 658-9500
(208) 658-9501
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
37496
CA
225100000X
Physical Therapist
Primary
PT-7140
ID
Other
Enumeration date
09/16/2014
Last updated
01/20/2021
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