Individual
MICHAEL S ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3814 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7591
(208) 529-3562
(208) 529-4064
Mailing address
3814 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7591
(208) 529-3562
(208) 529-4064
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1452
ID
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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