| Columbus Candies, PT MPA/HA PHD | |
|
1611 N Whitley Dr Ste 1a, Fruitland, ID 83619-2180 | |
| (208) 452-0021 | |
| (208) 452-0019 |
| Full Name | Columbus Candies |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist - Orthopedic |
| Location | 1611 N Whitley Dr Ste 1a, Fruitland, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366701948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | 1304798 (Texas) | Primary |
| 225100000X | Physical Therapist | PT-1689 (Idaho) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Columbus Candies, PT MPA/HA PHD 401 W Slaughter Ln, Ste 300, Austin, TX 78748-1774 Ph: (512) 888-1201 | Columbus Candies, PT MPA/HA PHD 1611 N Whitley Dr Ste 1a, Fruitland, ID 83619-2180 Ph: (208) 452-0021 |
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› Verified 6 days ago
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