Angela Gallatin, DPT
Individual provider Active NPI Physical Therapist · Rathdrum, ID
NPI 1962843649 · NPPES record last updated Mar 1, 2017
Key facts
- NPI
- 1962843649
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT- 3795 (ID)
- Practice address
- 14775 N Kimo CT Ste a
Rathdrum, ID 83858-8762 - Phone
- (208) 687-9240
- NPI assigned
- Jul 10, 2013
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT- 3795 | ID | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT- 3795 | ID | Yes |
Addresses
Primary practice location
14775 N Kimo CT Ste a
Rathdrum, ID 83858-8762
Mailing address
14094 N Pristine Cir
Rathdrum, ID 83858-6013
Phone (208) 691-8011
Other providers in Rathdrum, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2017. 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.