Misty Dawn Aguilar, DPT

Individual provider Active NPI Physical Therapist · Pocatello, ID

NPI 1447447602 · NPPES record last updated Oct 1, 2007

Key facts

NPI
1447447602
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT2270 (ID)
Practice address
1800 Garrett Way Ste 19a
Pocatello, ID 83201-5132
Phone
(208) 233-1064
Fax
(208) 233-0219
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT2270IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rapid Creek Rehab, PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2270 ID Yes

Addresses

Primary practice location

1800 Garrett Way Ste 19a
Pocatello, ID 83201-5132

Mailing address

1800 Garrett Way Ste 19a
Pocatello, ID 83201-5132
Phone (208) 233-1064

Other providers in Pocatello, ID

All providers in Pocatello, ID · Physical Therapist in Idaho

Sources for this page

Verify at the official NPI Registry.