Individual
KADE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1444 FALLS AVE E, TWIN FALLS, ID 83301-3408
(208) 736-2574
(208) 736-2594
Mailing address
1444 FALLS AVE E, TWIN FALLS, ID 83301-3408
(208) 736-2574
(208) 736-2594
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-4936
ID
225100000X
Physical Therapist
PT41787
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41787
STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
FL
01
—
PT-4936
ID STATE LICENSE
ID
Enumeration date
02/09/2017
Last updated
08/28/2024
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