Individual
BRIAN MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
12072 MCMILLAN RD, BOISE, ID 83713-2462
(208) 473-7546
Mailing address
12072 MCMILLAN RD, BOISE, ID 83713-2462
(208) 473-7546
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
36141
CA
225100000X
Physical Therapist
Primary
PT-2924
ID
Other
Enumeration date
10/28/2009
Last updated
09/13/2011
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