Doctor Name: | KELCI DENAE MAR |
NPI Number: | 1073920682 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | PT-3491 |
Business Practice Address: | 7979 W Rifleman St Suite 100 Boise, ID - 837049066 |
Business Phone Number: | 8055711000 |
Business Fax Number: | 8887119067 |
Mailing Address: | 7809 W Wesley Dr, BOISE |
State: | ID |
Postal Code: | 837047253 |
Phone Number: | 7854244846 |
Fax Number: | |
NPI Enumeration Date: | 07/15/2014 |
NPI Last Update Date: | 09/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT-3491 |
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 |