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Individual

ELLEN FERRENBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
64 S STAR RD, STAR, ID 83669-5497
(208) 488-4250
Mailing address
7719 W PREECE DR APT 102, BOISE, ID 83704-9088
(541) 654-1414

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6898
ID

Other

Enumeration date
05/27/2020
Last updated
05/27/2020
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