Individual
PHILLIP WADE KREISSLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1015 12TH AVE S, SUITE 105, NAMPA, ID 83651-4602
(208) 467-4357
(208) 467-4395
Mailing address
1015 12TH AVE S, SUITE 105, NAMPA, ID 83651-4602
(208) 467-4357
(208) 467-4395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2382
ID
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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