Individual
JUDITH MARIE WALBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA-245
Contact information
Practice address
1220 MONTANA ST, GOODING, ID 83330-1856
(208) 934-5601
Mailing address
1220 MONTANA ST, GOODING, ID 83330-1856
(208) 934-5601
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-245
ID
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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