Individual
DANA VAN WYCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4776 N FIVE MILE RD, BOISE, ID 83713-2715
(208) 658-9500
Mailing address
9419 COPPERTOP LOOP NE, BAINBRIDGE ISLAND, WA 98110-3647
(206) 842-2428
(206) 842-2890
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
07/08/2019
Last updated
04/16/2021
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