Individual
GINA MARIE FEMINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
524 CLEVELAND BLVD STE 110, CALDWELL, ID 83605-4079
(208) 455-5010
(208) 455-5020
Mailing address
6032 N GADWALL LN, BOISE, ID 83714-1284
(208) 484-0143
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-3051
ID
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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