Individual
DR. LUKE JACK HAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1233 N NORTHWOOD CENTER CT STE 101, COEUR D ALENE, ID 83814-6190
(208) 215-2450
(208) 773-1473
Mailing address
1233 N NORTHWOOD CENTER CT STE 101, COEUR D ALENE, ID 83814-6190
(208) 215-2450
(208) 773-1473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-6475
ID
2251S0007X
Sports Physical Therapist
PT-6475
ID
2251X0800X
Orthopedic Physical Therapist
PT-6475
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972135010
—
ID
Enumeration date
02/06/2020
Last updated
12/22/2023
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