Individual
TUNDRA MCDOUGAL I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
179 SW 5TH AVENUE, MERIDIAN, ID 83642
(208) 367-8282
Mailing address
179 SW 5TH AVENUE, MERIDIAN, ID 83642
(208) 367-8282
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1283
ID
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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