Provider Demographics
NPI:1083822472
Name:SCHOENSEE, SYDNEY KIM (PT)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:KIM
Last Name:SCHOENSEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12566 N SCHICKS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83714-9456
Mailing Address - Country:US
Mailing Address - Phone:208-229-0101
Mailing Address - Fax:
Practice Address - Street 1:600 ROBBINS RD
Practice Address - Street 2:SUITE 401
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4539
Practice Address - Country:US
Practice Address - Phone:208-383-0201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA139272251X0800X
ID18212251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic