| Performance Physical Therapy Of Idaho | |
|
450 W State St Ste 270, Eagle, ID 83616-6974 | |
| (925) 856-7007 | |
| Not Available |
| Full Name | Performance Physical Therapy Of Idaho |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 450 W State St Ste 270, Eagle, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295234367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (NU) | Primary |
| Provider Name | Matthew Candau |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457746067 PECOS PAC ID: 9436470069 Enrollment ID: I20170425002757 |
| Provider Name | Chad S Neubauer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619398393 PECOS PAC ID: 5395168587 Enrollment ID: I20200707000769 |
| Provider Name | Kathleen L Wesolowski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457365538 PECOS PAC ID: 8820081862 Enrollment ID: I20240812003901 |
| Mailing Address | Practice Location Address |
|---|---|
| Performance Physical Therapy Of Idaho 1940 S Bonito Way Ste 190, Meridian, ID 83642-5618 Ph: (208) 287-9420 | Performance Physical Therapy Of Idaho 450 W State St Ste 270, Eagle, ID 83616-6974 Ph: (925) 856-7007 |
Allison Andrews Boldridge, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 77 N Fisher Park Way, Eagle, ID 83616 Phone: 208-297-3039 |
Serin Kim, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 77 N Fisher Park Way, Eagle, ID 83616 Phone: 208-297-3039 Fax: 208-416-6635 |
Cameron Daron, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 645 E State St, Eagle, ID 83616 Phone: 208-939-9594 |
Kathryn L Stednitz, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 21 N Fisher Park Way, Eagle, ID 83616 Phone: 208-514-0670 |
Christopher Fox, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 645 E State St Ste 101, Eagle, ID 83616 Phone: 208-939-9594 Fax: 208-939-9828 |
Ryan Heilman, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 457 S Fitness Pl Ste 100, Eagle, ID 83616 Phone: 208-939-3332 Fax: 208-939-3338 |
Emily Verheijen, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 507 S Fitness Pl Ste 110, Eagle, ID 83616 Phone: 208-629-1030 Fax: 208-346-7618 |