Individual
KERBY ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
134 E IDAHO AVE, HOMEDALE, ID 83628-5003
(208) 337-3254
Mailing address
23605 RODEO LN, PARMA, ID 83660-7101
(208) 697-0270
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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