-- CHESS CARBOL --
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1760927834- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1578 MOUNTAIN SHADOW DR, POCATELLO, ID, 832045041
- Phone
- (208) 220-1369
Specialties & Taxonomies
Physical Therapy Assistant
Primary License: ID #4575
All Addresses
MAILING
1578 MOUNTAIN SHADOW DR
POCATELLO, ID, 832045041