Individual
MR. STEVEN GALE YULY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
457 S FITNESS PL, SUITE 100, EAGLE, ID 83616-6568
(208) 939-3332
(208) 939-3338
Mailing address
2311 E COMISKY ST, MERIDIAN, ID 83642-5301
(208) 939-3332
(208) 939-3338
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 1607
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010142240
BLUE SHIELD
—
05
—
8071990000
—
ID
01
—
TC530
BLUE CROSS
—
Enumeration date
10/05/2006
Last updated
07/08/2007
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