Individual
MR. DALLIN ROBERT LEIFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
3345 POTOMAC WAY, IDAHO FALLS, ID 83404-4978
(208) 233-2248
Mailing address
263 S STOUT AVE, BLACKFOOT, ID 83221-3230
(801) 389-6496
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-7487
ID
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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