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Individual

RYAN B HURST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
285 W FRANCIS ST, BLACKFOOT, ID 83221-1751
(208) 965-5850
(208) 782-1885
Mailing address
285 W FRANCIS ST, BLACKFOOT, ID 83221-1751
(208) 965-5850
(208) 782-1885

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2373
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010167780
BLUE SHIELD
ID
05
808114400
ID
01
TD745
BLUE CROSS
ID
Enumeration date
06/09/2008
Last updated
08/12/2008
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