| Ammon Benjamin Birk, DPT | |
|
940 Ballard Way, Kimberly, ID 83341 | |
| (801) 874-0479 | |
| Not Available |
| Full Name | Ammon Benjamin Birk |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 940 Ballard Way, Kimberly, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851889182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT-4245 (Idaho) | Primary |
| Provider Name | Dhhs Ihs Phoenix Area |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1356628028 PECOS PAC ID: 9436325420 Enrollment ID: O20120222000148 |
| Mailing Address | Practice Location Address |
|---|---|
| Ammon Benjamin Birk, DPT 940 Ballard Way, Kimberly, ID 83341-5162 Ph: (801) 874-0479 | Ammon Benjamin Birk, DPT 940 Ballard Way, Kimberly, ID 83341 Ph: (801) 874-0479 |
Reagan Ronald Ward, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 931 Center St W Ste C, Kimberly, ID 83341 Phone: 208-423-9999 Fax: 208-423-9998 | |
Trevor Baker Physical Therapy Physical Therapist Medicare: Medicare Enrolled Practice Location: 3463 E 3890 N, Kimberly, ID 83341 Phone: 208-644-0693 | |
Ashlyn Marie Zoon, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 931 Center St W Ste C, Kimberly, ID 83341 Phone: 208-423-9999 Fax: 208-423-9998 | |
Dr. Trevor John Baker, PT, DPT, GCS Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3463 E 3890 N, Kimberly, ID 83341 Phone: 208-644-0693 Fax: 208-231-8628 | |
Daniel Stark Russon, DPT, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 931 Center St W Ste C, Kimberly, ID 83341 Phone: 208-423-9999 Fax: 208-423-9998 |