Individual
WESTON STANWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1005 W AIRBASE RD, MOUNTAIN HOME, ID 83647-3339
(208) 587-1784
Mailing address
7550 W EMERALD ST, BOISE, ID 83704-9015
(208) 375-0765
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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