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Individual

BRETT E HAYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS.PT,

Contact information

Practice address
3035 W. MCMILLAN ROAD, SUITE 104, MERIDIAN, ID 83646-1080
(208) 887-8684
(208) 887-9226
Mailing address
3035 W. MCMILLAN ROAD, SUITE 104, MERIDIAN, ID 83646-1080
(208) 887-8684
(208) 887-9226

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2036
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010171917
REGENCE BLUE SHIELD
ID
05
807962600
ID
01
820520880
TRICARE
ID
01
TD821
BLUE CROSS
ID
Enumeration date
11/05/2007
Last updated
02/07/2012
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