Individual
HILARY O'BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
134 E IDAHO AVE, HOMEDALE, ID 83628-5003
(208) 337-3254
(208) 337-3264
Mailing address
2176 E FRANKLIN RD, SUITE 100, MERIDIAN, ID 83642-9024
(208) 288-1155
(208) 288-0424
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2701
ID
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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