Individual
TRAVIS BLAKE CRAIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
25305 ARROYO CT, CALDWELL, ID 83607-7916
(208) 863-1618
Mailing address
25305 ARROYO CT, CALDWELL, ID 83607-7916
(208) 863-1618
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2096
ID
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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