Individual
KELLY PATRICIA ISAKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
810 SOUTH MAIN, MOSCOW, ID 83843
(208) 883-1522
Mailing address
904 WHITE AVE, MOSCOW, ID 83843-3932
(208) 596-1056
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1348
ID
Other
Enumeration date
01/18/2007
Last updated
07/26/2017
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