IndividualActive
Heath Hicks, LPTA
NPI 1164845533 · Physical Therapy Assistant · Rexburg, ID
Provider details
- NPI number
- 1164845533
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- LPTA
- Sex
- Male
- Sole proprietor
- Yes
- License
- PTA-343 (ID)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
4442 Cedar Butte Cir
Rexburg, ID 83440-4320
Phone: (208) 351-0340
Approximate (ZIP-level) locationGet directions
Mailing address
4442 Cedar Butte Cir
Rexburg, ID 83440-4320
Registry dates
- Enumerated
- 2014-01-21
- Last updated
- 2014-01-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.