Individual
KASEY VITTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5255 W OVERLAND RD, BOISE, ID 83705-2637
(208) 338-9486
Mailing address
5255 W OVERLAND RD, BOISE, ID 83705-2637
(208) 338-9486
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-9128
ID
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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