Doctor Name: | MR. NICHOLAS P GREENWELL |
NPI Number: | 1669530119 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT |
License Number: | PT-1359 |
Business Practice Address: | 1263 Bennett Ave Suite 2 Burley, ID - 833182666 |
Business Phone Number: | 2086781191 |
Business Fax Number: | 2086781214 |
Mailing Address: | 1263 Bennett Ave, Ste 2 BURLEY |
State: | ID |
Postal Code: | 833184906 |
Phone Number: | 2086781191 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2006 |
NPI Last Update Date: | 02/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT-1359 |
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 |