Mikaela Virgin, PT | |
672 E Wythe Creek Ct, Kuna, ID 83634-5216 | |
(208) 922-9828 | |
Not Available |
Full Name | Mikaela Virgin |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 672 E Wythe Creek Ct, Kuna, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871210500 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 8477 (Idaho) | Primary |
Provider Name | Altitude Physical Therapy Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1619045309 PECOS PAC ID: 0244267029 Enrollment ID: O20050722000897 |
Mailing Address | Practice Location Address |
---|---|
Mikaela Virgin, PT 1185 E Trophy St, Kuna, ID 83634-3541 Ph: (503) 577-8901 | Mikaela Virgin, PT 672 E Wythe Creek Ct, Kuna, ID 83634-5216 Ph: (208) 922-9828 |
Derek James Wasden, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 943 N Linder Rd Ste 104, Kuna, ID 83634 Phone: 208-972-4612 Fax: 208-991-1595 | |
Alyssa Parco, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 672 E Wythe Creek Ct Ste 103, Kuna, ID 83634 Phone: 208-922-9828 | |
Ava Elizabeth Lowell, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 672 E Wythe Creek Ct, Kuna, ID 83634 Phone: 208-992-9828 | |
Andrew Boynton, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 943 N Linder Rd Ste 104, Kuna, ID 83634 Phone: 208-922-1719 Fax: 208-922-1721 | |
Alexis Pettersen, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 672 E Wythe Creek Ct, Kuna, ID 83634 Phone: 208-922-9828 | |
Robert Gray Vining Iii, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 943 N Linder Rd, Suite 104, Kuna, ID 83634 Phone: 208-922-1719 Fax: 208-322-8710 | |
Suzanne Baker Stewart, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 333 Avenue C, Suite 3, Kuna, ID 83634 Phone: 208-922-5057 |