Individual
MIKAELA VIRGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
672 E WYTHE CREEK CT, KUNA, ID 83634-5216
(208) 922-9828
Mailing address
1185 E TROPHY ST, KUNA, ID 83634-3541
(503) 577-8901
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8477
ID
Other
Enumeration date
10/24/2022
Last updated
10/27/2022
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