Individual
LISA JOANN DARST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
601 W CAMERON AVE, MOUNTAIN VALLEY CARE & REHABILITATION CENTER, KELLOGG, ID 83837-2004
(208) 784-1283
(208) 784-0151
Mailing address
POB 6, KELLOGG, ID 83837
(208) 661-9180
(208) 682-2735
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
RPT-855
ID
Other
Enumeration date
05/22/2008
Last updated
12/17/2018
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