Individual
NICHOLAS HAYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
901 N CURTIS RD, BOISE, ID 83706-1338
(208) 367-2121
Mailing address
1501 N 21ST ST, BOISE, ID 83702-0728
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5161
ID
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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