Provider Demographics
NPI:1457518433
Name:ESPLIN, CRAIG (PT)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:ESPLIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14497 W KENSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-0975
Mailing Address - Country:US
Mailing Address - Phone:208-938-6002
Mailing Address - Fax:
Practice Address - Street 1:995 S HILTON ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-1960
Practice Address - Country:US
Practice Address - Phone:208-344-9915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-1529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist