NPI 1053525964

Rose Marie Raube, PTA

Practitioner Specialist Driggs, ID

Practice location

Address: 120 E Howard St, Driggs, ID 83422-5112
Phone: (208) 354-3128
Mailing address: 375 Bustle Creek Road, Alta, WY 83414-4505

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence PTA390 (ID)

Other Specialist providers in Idaho →

Registry record

NPI: 1053525964
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 May 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.