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Individual

KEVIN WESLEY WARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1800 FLANDRO DR, SUITE 190, POCATELLO, ID 83202-4912
(208) 233-2248
Mailing address
1800 FLANDRO DR, SUITE 190, POCATELLO, ID 83202-4912
(208) 233-2248

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2386
ID

Other

Enumeration date
05/15/2015
Last updated
05/15/2015
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