Individual
DENISE MICHELE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1142 N SNEAD PL, EAGLE, ID 83616-6529
(208) 941-3394
Mailing address
1142 N SNEAD PL, EAGLE, ID 83616-6529
(208) 941-3394
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1546
ID
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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