Individual
KYLE DONOVAN MAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1001 S HILTON ST, BOISE, ID 83705-1925
(509) 552-6910
Mailing address
1001 S HILTON ST, BOISE, ID 83705-1925
(509) 552-6910
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3478
ID
Other
Enumeration date
06/17/2014
Last updated
06/20/2014
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