Mrs. DAELENE SUEANN TIBBITTS -- PTA
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1891247912- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PTA
- Status
- Active
Contact & Location
- Address
- 1665 E 5TH N, MOUNTAIN HOME, ID, 83647
- Phone
- (208) 598-5047
Specialties & Taxonomies
Physical Therapy Assistant
Primary License: ID #PTA-4637