Scanlan, Stacey L

Scanlan, Stacey L is an individual health care provider with primary practice located at 2302 N Bogus Basin Road Suite C, Boise ID 83702. She 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 / Orthopedic. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Scanlan, Stacey L can be contacted via phone (208) 344-0730.

Contact Information

Primary practice address
2302 N Bogus Basin Road Suite C Boise ID 83702
Phone: (208) 344-0730
Fax: (208) 344-0759
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT1355 Idaho
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X PT1355 Idaho

Profile Details

NPI number 1689756603
LBN Legal business name Scanlan, Stacey L
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Oct 7th, 2011 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1689756603 NPPES
Idaho MEDICAID 102560035
Idaho Other 1578799094

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