Individual
MR. KEVIN DOUGLAS RACINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1618 S MILLENIUM WAY STE 210, MERIDIAN, ID 83642-6457
(208) 884-4647
(208) 884-8984
Mailing address
645 E STATE ST STE 101, EAGLE, ID 83616-5915
(208) 939-9594
(208) 939-9828
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-6627
ID
Other
Enumeration date
02/13/2020
Last updated
02/13/2020
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