Mr Dallin Robert Leifson, PT, DPT | |
3345 Potomac Way, Idaho Falls, ID 83404-4978 | |
(208) 233-2248 | |
Not Available |
Full Name | Mr Dallin Robert Leifson |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 3 Years |
Location | 3345 Potomac Way, Idaho Falls, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972171114 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT-7487 (Idaho) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Mcdonald Rehab, Pc | 2163505603 | 14 |
Provider Name | Mcdonald Rehab, Pc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1497948509 PECOS PAC ID: 2163505603 Enrollment ID: O20080207000254 |
Mailing Address | Practice Location Address |
---|---|
Mr Dallin Robert Leifson, PT, DPT 263 S Stout Ave, Blackfoot, ID 83221-3230 Ph: (801) 389-6496 | Mr Dallin Robert Leifson, PT, DPT 3345 Potomac Way, Idaho Falls, ID 83404-4978 Ph: (208) 233-2248 |
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