Individual
RYAN HENDRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1224 E HAYDEN ST, POCATELLO, ID 83201-4726
(208) 283-2748
Mailing address
1224 E HAYDEN ST, POCATELLO, ID 83201-4726
(208) 283-2748
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3634
ID
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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