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3463 E 3890 N, Kimberly, ID 83341-5508 | |
(208) 644-0693 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 3463 E 3890 N, Kimberly, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1235743436 | NPI | - | NPPES |
Provider Name | Trevor John Baker |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1912496753 PECOS PAC ID: 0648681759 Enrollment ID: I20201125001637 |
Mailing Address | Practice Location Address |
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3463 E 3890 N, Kimberly, ID 83341-5508 Ph: (208) 644-0693 | 3463 E 3890 N, Kimberly, ID 83341-5508 Ph: (208) 644-0693 |