Spencer Reid Calhoun, PT, DPT
Individual provider Active NPI Physical Therapist · Eagle, ID
NPI 1609488303 · NPPES record last updated Aug 24, 2020
Key facts
- NPI
- 1609488303
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT-6977 (ID)
- Practice address
- 2411 E Riverside Dr Apt P308
Eagle, ID 83616-7573 - Phone
- (912) 675-8944
- NPI assigned
- Aug 24, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-6977 | ID | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-6977 | ID | Yes |
Addresses
Primary practice location
2411 E Riverside Dr Apt P308
Eagle, ID 83616-7573
Mailing address
2411 E Riverside Dr Apt P308
Eagle, ID 83616-7573
Phone (912) 675-8944
Other providers in Eagle, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.