NPI 1225390305

Deidra Nichols, DPT

Practitioner Physical Therapist Shelley, ID

Practice location

Address: 650 N State St, Shelley, ID 83274-4900
Phone: (208) 782-4744
Fax: (208) 906-1554

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence PT3043 (ID)

Other Physical Therapist providers in Idaho →

Registry record

NPI: 1225390305
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Jun 2012
Record last updated: 31 Dec 2019

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.