Individual
CASSIE ANNE LIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
6855 W FAIRVIEW AVE, BOISE, ID 83704-8046
(208) 323-8888
Mailing address
2411 E RIVERSIDE DR APT Q304, EAGLE, ID 83616-7576
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT-7021
ID
Other
Enumeration date
08/11/2020
Last updated
01/23/2025
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