Individual
MR. MARK LOWELL OSADCHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.P.T.
Contact information
Practice address
3310 VALENCIA DR, IDAHO FALLS, ID 83404-7502
(208) 520-4041
(208) 745-9477
Mailing address
PO BOX 3914, IDAHO FALLS, ID 83403-3914
(208) 520-4041
(208) 745-9477
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT-1001
ID
Other
Enumeration date
11/28/2006
Last updated
07/09/2007
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