Individual
ELAINE J SPANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
50 SKI HILL RD, DRIGGS, ID 83422
(208) 354-3128
(208) 354-3128
Mailing address
PO BOX 1612, IDAHO FALLS, ID 83403-1612
(208) 525-2090
(208) 525-2662
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA222
ID
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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