Individual
RILEY D WALDECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3157 E BARBER VALLEY DR STE 120, BOISE, ID 83716-4770
(208) 901-8477
(208) 629-7529
Mailing address
1411 FALLS AVE E STE 401, TWIN FALLS, ID 83301-3455
(208) 901-8477
(208) 629-7529
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT8820
ID
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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