Provider Demographics
NPI:1568621282
Name:BROWNING, CHRYSTAL DAWN (PT, DPT, PCS)
Entity Type:Individual
Prefix:
First Name:CHRYSTAL
Middle Name:DAWN
Last Name:BROWNING
Suffix:
Gender:F
Credentials:PT, DPT, PCS
Other - Prefix:
Other - First Name:CHRYSTAL
Other - Middle Name:DAWN
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, PCS
Mailing Address - Street 1:650 N STATE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:SHELLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83274-4900
Mailing Address - Country:US
Mailing Address - Phone:208-221-4677
Mailing Address - Fax:208-209-6079
Practice Address - Street 1:650 N STATE ST STE 5
Practice Address - Street 2:
Practice Address - City:SHELLEY
Practice Address - State:ID
Practice Address - Zip Code:83274-4900
Practice Address - Country:US
Practice Address - Phone:208-221-4677
Practice Address - Fax:208-209-6079
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-23662251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics