| Taylor N Williams, DPT LICENSE: PT-6769 | |
|
875 E Plaza Dr, Eagle, ID 83616-6548 | |
| (208) 939-0886 | |
| (208) 939-1131 |
| Full Name | Taylor N Williams |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 875 E Plaza Dr, Eagle, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639793953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2251X0800X | Physical Therapist - Orthopedic | PT-6769 (Idaho) | Secondary |
| 225100000X | Physical Therapist | PT-6769 (Idaho) | Primary |
| Provider Name | Physical Therapy 180 Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1669696910 PECOS PAC ID: 9830422955 Enrollment ID: O20190605000354 |
| Mailing Address | Practice Location Address |
|---|---|
| Taylor N Williams, DPT LICENSE: PT-6769 875 E Plaza Dr Ste 103, Eagle, ID 83616-6549 Ph: (208) 939-0886 | Taylor N Williams, DPT LICENSE: PT-6769 875 E Plaza Dr, Eagle, ID 83616-6548 Ph: (208) 939-0886 |
Allison Andrews Boldridge, P.T. Physical Therapist Medicare: Medicare Enrolled 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: May Accept Medicare Assignments Practice Location: 645 E State St, Eagle, ID 83616 Phone: 208-939-9594 | |
Kathryn L Stednitz, DPT Physical Therapist Medicare: Medicare Enrolled 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: Medicare Enrolled 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 |