Individual
KEVIN JOHN SGROI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
8300 N WAYNE DR, HAYDEN, ID 83835-6027
(208) 772-9774
(208) 772-9564
Mailing address
8300 N WAYNE DR, HAYDEN, ID 83835-6027
(208) 772-9774
(208) 772-9564
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1457
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807014300
—
ID
Enumeration date
10/04/2006
Last updated
01/23/2023
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