Lindsey E Decloss (NPI# 1194822528, PAC ID# 6608875208) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
Nation Provider ID (NPI) | 1194822528 |
PAC ID by PECOS | 6608875208 |
Professional Enrollment ID | I20150309000815 |
Full Name | Lindsey E Decloss |
Organization Legal Name | NICHOLS THERAPY GROUP P.C. |
Address |
9652 W State St Northstar Physical Therapy Star ID 83669-5858 |
Phone Number | 2082860766 |
Gender | F |
Graduation Year | 2005 |
Primary Specialty | PHYSICAL THERAPY |
Group Practice PAC ID | 0345229068 |
Number of Group Practice Members | 4 |
Accepts Medicare Assignment | Y |
Address | Phone | Organization |
---|---|---|
9652 W State St, Northstar Physical Therapy, Star, ID 83669-5858 | 2082860766 | NICHOLS THERAPY GROUP P.C. |
Organization Legal Name | NICHOLS THERAPY GROUP P.C. |
Physicians | 4 |
Name | Specialty | Organization | Address |
---|---|---|---|
Judianne K Nichols | Physical Therapy | Nichols Therapy Group P.C. | 9652 W State St, Northstar Physical Therapy, Star, ID 83669-5858 |
Brian M Holgate | Physical Therapy | Nichols Therapy Group P.C. | 9652 W State St, Northstar Physical Therapy, Star, ID 83669-5858 |
Brian D Nichols | Physical Therapy | Nichols Therapy Group P.C. | 9652 W State St, Northstar Physical Therapy, Star, ID 83669-5858 |
Street Address |
9652 W STATE ST NORTHSTAR PHYSICAL THERAPY |
City | STAR |
State | ID |
Zip | 83669-5858 |
Name | Specialty | Organization | Address |
---|---|---|---|
Judianne K Nichols | Physical Therapy | Nichols Therapy Group P.C. | 9652 W State St, Northstar Physical Therapy, Star, ID 83669-5858 |
Brian M Holgate | Physical Therapy | Nichols Therapy Group P.C. | 9652 W State St, Northstar Physical Therapy, Star, ID 83669-5858 |
Brian D Nichols | Physical Therapy | Nichols Therapy Group P.C. | 9652 W State St, Northstar Physical Therapy, Star, ID 83669-5858 |
Name | Specialty | Organization | Address |
---|---|---|---|
Beverlee K Furner | Nurse Practitioner | 9858 W State St, Star, ID 83669-5210 | |
Jonathan S Link | Physical Therapy | Boise River Physical Therapy | 64 S Star Rd, Star, ID 83669-5497 |
City | STAR |
Zip Code | 83669 |
Specialty | PHYSICAL THERAPY |
City + Specialty | STAR + PHYSICAL THERAPY |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.