Provider Demographics
NPI:1942408455
Name:HESSLER, PATRICK OMURA (DPT)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:OMURA
Last Name:HESSLER
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 1:1347 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1770
Mailing Address - Country:US
Mailing Address - Phone:208-888-7919
Mailing Address - Fax:
Practice Address - Street 1:1818 S 10TH AVE
Practice Address - Street 2:STE 100
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-4803
Practice Address - Country:US
Practice Address - Phone:208-454-0505
Practice Address - Fax:208-454-0559
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1873225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist