Individual
DR. KATHLEEN BOSTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,DPT,MOT,OTR/L
Contact information
Practice address
222 SHOSHONE ST E, TWIN FALLS, ID 83301-6105
(775) 530-5091
Mailing address
2164 NISQUALLY ST, TWIN FALLS, ID 83301-5687
(775) 530-5091
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13347
CO
225100000X
Physical Therapist
5024
ID
225X00000X
Occupational Therapist
1715
ID
225X00000X
Occupational Therapist
4285
CO
Other
Enumeration date
05/16/2016
Last updated
03/17/2018
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