| Ms Kimberly J Mazzella, PT | |
|
875 S Vanguard Way Ste 110, Meridian, ID 83642-8541 | |
| (208) 960-0932 | |
| (208) 960-0935 |
| Full Name | Ms Kimberly J Mazzella |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 875 S Vanguard Way Ste 110, Meridian, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730110982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT-7231 (Idaho) | Primary |
| Provider Name | Therapeutic Associates Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1487630240 PECOS PAC ID: 0042116279 Enrollment ID: O20040515000415 |
| Provider Name | Nichols Therapy Group P.c. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1043380769 PECOS PAC ID: 0345229068 Enrollment ID: O20040716000273 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Kimberly J Mazzella, PT 875 S Vanguard Way Ste 110, Meridian, ID 83642-8541 Ph: (208) 960-0930 | Ms Kimberly J Mazzella, PT 875 S Vanguard Way Ste 110, Meridian, ID 83642-8541 Ph: (208) 960-0932 |
Dr. Kennedy Poplawski Gillespie, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 90 E Ustick Rd Ste 150, Meridian, ID 83646 Phone: 208-895-0715 Fax: 208-895-0746 | |
Mr. Matthew Lyle Walker, MPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2321 E Gala St, Suite 1, Meridian, ID 83642 Phone: 208-888-4321 Fax: 208-895-8747 | |
Robin Mcgaw Hughes, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 520 S Eagle Rd, Meridian, ID 83642 Phone: 208-381-4757 Fax: 208-706-5538 | |
Jennifer Ellen Eikanger, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 875 S Vanguard Way Ste 110, Meridian, ID 83642 Phone: 208-960-0930 Fax: 208-960-0935 | |
Touchmark At Meadow Lake Village Outpatient Clinic Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4037 E Clocktower Ln, Meridian, ID 83642 Phone: 208-888-2277 Fax: 208-888-9159 | |
Abigail Jorgensen, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 520 S Eagle Rd, Meridian, ID 83642 Phone: 208-706-5000 | |
Kai Lamont Turner, PT, DPT, CSCS Physical Therapist Medicare: Medicare Enrolled Practice Location: 2204 E Lanark St Ste 100, Meridian, ID 83642 Phone: 208-908-7908 Fax: 208-908-7935 |