Individual
TYLER EGBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
429 N IDAHO ST, WENDELL, ID 83355-5050
(208) 536-3090
(208) 536-3090
Mailing address
3121 EAGLE RIDGE DR, WENDELL, ID 83355-3340
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-7991
ID
Other
Enumeration date
09/08/2016
Last updated
11/29/2023
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