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PEGGY GOODMAN P.T.

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1740680404

Individual Registrant:
 PEGGY  GOODMAN P.T.
Gender: F
Sole Proprietor

Location and contact information for practice:
610 18TH ST  RUPERT, ID 83350-1027 US
Tel: 208-431-3444  Fax: --

Contact information for business:
610 18TH ST  RUPERT, ID 83350-1027 US
Tel: 208-431-3444  Fax: --

Registration Information:
NPI: 1740680404
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
IDPT-253

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS ID - Page 1

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