IndividualActive
Madison De Loera
NPI 1740827385 · Physical Medicine & Rehabilitation Physician · Idaho Falls, ID
Provider details
- NPI number
- 1740827385
- Entity type
- Individual
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- PTA-6160 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
720 S Woodruff Ave
Idaho Falls, ID 83401-5285
Phone: (208) 552-5025
Approximate (ZIP-level) locationGet directions
Mailing address
720 S Woodruff Ave
Idaho Falls, ID 83401-5285
Registry dates
- Enumerated
- 2019-12-02
- Last updated
- 2019-12-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.