Provider Demographics
NPI:1093156689
Name:ENGLISH, MINDY (DPT)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 N CURTIS RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-1338
Mailing Address - Country:US
Mailing Address - Phone:208-367-3315
Mailing Address - Fax:
Practice Address - Street 1:901 N CURTIS RD
Practice Address - Street 2:SUITE 204
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-1338
Practice Address - Country:US
Practice Address - Phone:208-367-3315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-3244225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1093156689Medicaid
ID0327663OtherWA L&I
ID0327665OtherWA L&I
ID0327664OtherWA L&I
ID0330317OtherWA L&I
ID0327691OtherWA L&I
ID20005247Medicare PIN