Kodak, Mary A

Kodak, Mary A is an individual health care provider with primary practice located at 500 W Aqua Ave , Coeur D Alene ID 83815-7764. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Kodak, Mary A can be contacted via phone (208) 762-1122.

Contact Information

Primary practice address
500 W Aqua Ave Coeur D Alene ID 83815-7764
Phone: (208) 762-1122
Fax: (208) 762-1680
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X PTA 0313 Idaho

Profile Details

NPI number 1427216928
LBN Legal business name Kodak, Mary A
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2008
Last updated May 30th, 2008 - about 17 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.

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