IndividualActive
David Thibodeau
NPI 1811720550 · Physical Therapy Assistant · Driggs, ID
Provider details
- NPI number
- 1811720550
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- PA6882 (ME)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
285 E Little Ave
Driggs, ID 83422-5137
Phone: (208) 354-1999
Approximate (ZIP-level) locationGet directions
Mailing address
2146 Highland Way
Victor, ID 83455-5411
Registry dates
- Enumerated
- 2024-08-20
- Last updated
- 2024-08-20
- Certified
- 2024-08-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.