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Individual

RYAN PATRICK DONAHUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
600 N ROBBINS RD, BOISE, ID 83702-4565
(208) 489-4444
Mailing address
1728 S ANNETT ST, BOISE, ID 83705-3168
(651) 210-4117

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1942
ID

Other

Enumeration date
02/11/2014
Last updated
02/11/2014
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