Individual
DAREN A STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
280 E JACKSON ST, MOUNTAIN HOME, ID 83647-2708
(208) 991-8487
Mailing address
280 E JACKSON ST, MOUNTAIN HOME, ID 83647-2708
(208) 590-7088
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2466
ID
225100000X
Physical Therapist
2582
NE
Other
Enumeration date
11/26/2007
Last updated
05/06/2020
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