Mr Bruce J Wallentine, MPT is a
Physical Therapist based in Ovid, Idaho. Mr Bruce J Wallentine is licensed to practice in Idaho (license number PT-593) and his current practice location is
900 Lanark Rd, Ovid, Idaho. He can be reached at his office (for appointments etc.) via phone at
(208) 945-2900.
NPI number for Mr Bruce J Wallentine is 1023129251 and his current mailing address is 900 Lanark Rd, Ovid, Idaho. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1023129251.
Healthcare Provider's Profile
| Full Name | Mr Bruce J Wallentine |
|---|
| Gender | Male |
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| Speciality | Physical Therapist |
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| Location | 900 Lanark Rd, Ovid, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1023129251
- Provider Enumeration Date: 08/31/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Bruce J Wallentine such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023129251 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | PT-593 (Idaho) | Primary |
| 225100000X | Physical Therapist | PT-389 (Wyoming) | Secondary |
| 225100000X | Physical Therapist | 362968-2401 (Utah) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Bruce J Wallentine is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Bruce J Wallentine, MPT
900 Lanark Rd,
Ovid, ID 83254-4934
Ph: (208) 945-2900 | Mr Bruce J Wallentine, MPT
900 Lanark Rd,
Ovid, ID 83254-4934
Ph: (208) 945-2900 |
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