Individual
MS. MISTY DAWN AGUILAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1800 GARRETT WAY STE 19A, POCATELLO, ID 83201-5132
(208) 233-1064
(208) 233-0219
Mailing address
1800 GARRETT WAY STE 19A, POCATELLO, ID 83201-5132
(208) 233-1064
(208) 233-0219
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2270
ID
Other
Enumeration date
10/01/2007
Last updated
10/01/2007
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