Individual
MS. KATHRYN ELIZABETH MACOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T.
Contact information
Practice address
8660 W EMERALD ST STE 112, BOISE, ID 83704-4829
(208) 321-7831
Mailing address
856 W CAGNEY ST, MERIDIAN, ID 83646-5297
(208) 724-3870
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1608
ID
Other
Enumeration date
06/17/2007
Last updated
11/09/2016
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