IndividualActive
Daelene Tibbitts, PTA
NPI 1891247912 · Physical Therapy Assistant · Mountain Home, ID
Provider details
- NPI number
- 1891247912
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- Yes
- License
- PTA-4637 (ID)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1665 E 5th N
Mountain Home, ID 83647
Phone: (208) 598-5047
Approximate (ZIP-level) locationGet directions
Mailing address
1665 E 5th N
Mountain Home, ID 83647
Registry dates
- Enumerated
- 2016-10-25
- Last updated
- 2016-10-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.