Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251X0800X | Physical Therapist - Orthopedic | 13927 | CA |
Y | 2251X0800X | Physical Therapist - Orthopedic | 1821 | ID |
NPI | 1083822472 |
---|---|
Provider Name | Sydney Kim Schoensee |
First Address | Boise, ID 83714-9456 |
Second Address | Boise, ID 83702-4539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 14/11/2008 |