Individual
JOSEPH RICHARD PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 HOPE DR, MOUNTAIN HOME AFB, ID 83648-1057
(208) 828-7900
Mailing address
90 HOPE DR, MOUNTAIN HOME AFB, ID 83648-1057
(208) 828-7900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13879-24
WI
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14056178
CAQH
WI
Enumeration date
07/27/2017
Last updated
04/09/2024
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