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Individual

KELLI DUREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12263 W HICKORY DR, BOISE, ID 83713-1433
(208) 390-9032
Mailing address
12263 W HICKORY DR, BOISE, ID 83713-1433

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-3189
ID

Other

Enumeration date
06/27/2014
Last updated
06/27/2014
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