Deanna C. Dye, PT

Individual provider Active NPI Physical Therapist · Pocatello, ID

NPI 1891848347 · NPPES record last updated Aug 30, 2016

Key facts

NPI
1891848347
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT1657 (ID)
Practice address
650 Memorial Dr
BLDG #68
Pocatello, ID 83209-0001
Phone
(208) 282-3495
NPI assigned
Jan 19, 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
PT1657IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho State University Physical Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1657 ID Yes

Addresses

Primary practice location

650 Memorial Dr
BLDG #68
Pocatello, ID 83209-0001

Mailing address

921 S 8TH Ave
Stop 8045
Pocatello, ID 83209-0002
Phone (208) 282-4307

Other providers in Pocatello, ID

All providers in Pocatello, ID · Physical Therapist in Idaho

Sources for this page

Verify at the official NPI Registry.