Individual
MARY ELIZABETH GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
PT, DPT
Contact information
Practice address
1460 ELK CREEK DR, IDAHO FALLS, ID 83404-8237
(208) 535-1286
Mailing address
1460 ELK CREEK DR, IDAHO FALLS, ID 83404-8237
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
4771149
ID
Other
Enumeration date
03/17/2025
Last updated
03/17/2025
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