Angela Babb Anderson, PT

Individual provider Active NPI Physical Therapist · Pocatello, ID

NPI 1902370141 · NPPES record last updated Jan 21, 2019

Key facts

NPI
1902370141
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT1473 (ID)
Practice address
527 Memorial Dr
Pocatello, ID 83201-4063
Phone
(208) 478-3333
Fax
(208) 478-3329
NPI assigned
Jan 21, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT1473IDMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1473 ID Yes

Addresses

Primary practice location

527 Memorial Dr
Pocatello, ID 83201-4063

Mailing address

527 Memorial Dr
Pocatello, ID 83201-4063
Phone (208) 478-3333

Other providers in Pocatello, ID

All providers in Pocatello, ID · Physical Therapist in Idaho

Sources for this page

Verify at the official NPI Registry.