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Individual

DAVID B HUTCHINSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
423 IDAHO ST STE A, GOODING, ID 83330-1258
(208) 934-9011
(208) 934-9014
Mailing address
423 IDAHO ST STE A, GOODING, ID 83330-1258
(208) 934-9011
(208) 934-9014

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10145012
BLUE SHIELD
ID
01
571155611
TRICARE
ID
05
806724700
ID
01
P00099594
RAILROAD MEDICARE
ID
01
T8810
BLUE CROSS
ID
Enumeration date
04/25/2006
Last updated
10/28/2008
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