Individual
MR. STEPHEN BLAKE MILTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
520 S EAGLE RD, MERIDIAN, ID 83642-6351
(208) 706-5000
Mailing address
PO BOX 1474, BOISE, ID 83701-1474
(303) 744-3571
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6822
ID
Other
Enumeration date
03/26/2020
Last updated
03/26/2020
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