Andersen, David Lynn

Andersen, David Lynn is an sole proprietor health care provider with primary practice located at 363 Tyra Dr , Idaho Falls ID 83401-4437. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Andersen, David Lynn can be contacted via phone (208) 681-2525.

Contact Information

Primary practice address
363 Tyra Dr Idaho Falls ID 83401-4437
Phone: (208) 681-2525
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT-322 Idaho
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X AT-004 Idaho

Profile Details

NPI number 1265657001
LBN Legal business name Andersen, David Lynn
Credentials R.P.T., L.A.T, A.T.C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 16th, 2007
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1265657001 NPPES
Idaho MEDICAID 0043961

Popular Providers