Individual
MICHAEL D WHITNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1590 E POLSTON AVE, STE B, POST FALLS, ID 83854-5218
(208) 777-4242
(208) 777-4020
Mailing address
1590 E POLSTON AVE, STE B, POST FALLS, ID 83854-5218
(208) 777-4242
(208) 777-4020
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT00007703
WA
225100000X
Physical Therapist
Primary
PT1365
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
ID
01
—
PT 1365
IDAHO LICENSE
ID
Enumeration date
07/25/2006
Last updated
01/02/2008
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