Organization
CNC, INC.
Active
Organization
CNC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES G RIDDLE II PT, DPT (OWNER)
(208) 895-0022
Entity
Organization
Contact information
Practice address
3140 W MILANO DR, SUITE 100, MERIDIAN, ID 83646-7290
(208) 895-0022
(208) 898-9308
Mailing address
3140 W MILANO DR, SUITE 100, MERIDIAN, ID 83646-7290
(208) 895-0022
(208) 898-9308
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1978
ID
Other
Enumeration date
02/05/2013
Last updated
02/05/2013
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