Individual
BRAD EDWARD SHARPLES-FAUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
104 W 9TH AVE, POST FALLS, ID 83854-9216
(208) 777-9740
(208) 777-8316
Mailing address
104 W 9TH AVE, POST FALLS, ID 83854-9216
(208) 777-9740
(208) 777-8316
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1228
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806161100
—
ID
Enumeration date
07/04/2006
Last updated
11/23/2022
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