Individual
GWENDOLYN BLYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
520 S EAGLE RD, MERIDIAN, ID 83642-6351
(208) 706-5537
Mailing address
1410 E RIVERS END DR, EAGLE, ID 83616-6385
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2236
ID
Other
Enumeration date
09/02/2016
Last updated
09/02/2016
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