Individual
MRS. ALEXANDRIA MYKAEL SCHOONOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 E PINE ST, CALDWELL, ID 83605-4836
(208) 454-5142
Mailing address
11127 W BLAINE AVE, NAMPA, ID 83651-5089
(208) 404-6942
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5044
ID
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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