Individual
MR. MARK ALLEN REED
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1015 12TH AVE S, STE 105, NAMPA, ID 83651
(208) 467-4357
(208) 467-4395
Mailing address
1015 12TH AVE S, STE 105, NAMPA, ID 83651
(208) 467-4357
(208) 467-4395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT854
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010150640
BLUE SHIELD OF ID
—
01
—
TC548
BLUE CROSS OF ID
—
Enumeration date
03/27/2006
Last updated
07/08/2007
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