Individual
JOSEPH GORRICETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
527 MEMORIAL DR, POCATELLO, ID 83201-4063
(208) 478-3333
Mailing address
1667 S LEE AVE, IDAHO FALLS, ID 83404-6033
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3110
ID
Other
Enumeration date
01/21/2019
Last updated
01/21/2019
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