NPI 1083141394

Nohe Mata, PTA

Practitioner Physical Therapy Assistant Nampa, ID

Practice location

Address: 4301 Garrity Blvd STE 103, Nampa, ID 83687-9222
Phone: (208) 463-0700
Fax: (208) 463-0700
Mailing address: 1010 Holly St, Nampa, ID 83686-5825

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence PTA-5158 (ID)

Other Physical Therapy Assistant providers in Idaho →

Registry record

NPI: 1083141394
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 May 2017
Record last updated: 17 May 2017

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.