Individual
TEISHA BANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
910 E WASHINGTON ST, BOISE, ID 83712-7321
(208) 570-3004
Mailing address
910 E WASHINGTON ST, BOISE, ID 83712-7321
(208) 570-3004
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7030
ID
225100000X
Physical Therapist
PT7030
ID
Other
Enumeration date
10/14/2020
Last updated
07/08/2025
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