Doctor Name: | DR. ANGELA KAYE MOORE TANAKA |
NPI Number: | 1053498543 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | PT-2022 |
Business Practice Address: | 2475 S Ammon Rd Suite #108 Ammon, ID - 834066849 |
Business Phone Number: | 2085696599 |
Business Fax Number: | 2085522180 |
Mailing Address: | 5292 Tildy Cir, IDAHO FALLS |
State: | ID |
Postal Code: | 834016017 |
Phone Number: | 2085696599 |
Fax Number: | 2085522180 |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT-2022 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |