Individual
CASEY MICHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1351 W PINE AVE, MERIDIAN, ID 83642-5031
(208) 888-7049
Mailing address
3204 WISCONSIN AVE, CALDWELL, ID 83605-6409
(208) 250-4203
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT - 4156
ID
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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