Provider Demographics
NPI:1215392204
Name:CALL, ANSON C (DPT)
Entity Type:Individual
Prefix:
First Name:ANSON
Middle Name:C
Last Name:CALL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 W 6TH S
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:ID
Mailing Address - Zip Code:83647-3339
Mailing Address - Country:US
Mailing Address - Phone:208-587-1777
Mailing Address - Fax:208-587-1784
Practice Address - Street 1:1005 W 6TH S
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:ID
Practice Address - Zip Code:83647-3339
Practice Address - Country:US
Practice Address - Phone:208-587-1777
Practice Address - Fax:208-587-1784
Is Sole Proprietor?:No
Enumeration Date:2015-12-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT4320225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist