Individual
MAKENA MUELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC
Contact information
Practice address
775 S RIVERSHORE LN STE 220, EAGLE, ID 83616-5783
(208) 629-1030
Mailing address
2717 W BANNOCK ST, BOISE, ID 83702-4759
(719) 432-6943
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
07/08/2019
Last updated
02/27/2025
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