Individual
LANCE OLE EINERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2932 N EAGLE RD UNIT 100, MERIDIAN, ID 83646-6251
(208) 380-4898
Mailing address
1525 W SOLDOTNA DR, KUNA, ID 83634-5455
(208) 380-4898
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-6222
ID
Other
Enumeration date
08/08/2019
Last updated
07/12/2024
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