Individual
ERIC ANDREASEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
393 EAST SECOND NORTH, REXBURG, ID 83440
(208) 359-9570
Mailing address
475 CITY STREET, PO BOX 173, NEWDALE, ID 83436
(208) 458-4721
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1527
ID
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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