Basic Information
| Provider Information | |||||||||
| NPI: | 1013644178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEDINE | ||||||||
| FirstName: | EMILY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 364 N BAY ST APT B12 | ||||||||
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| City: | POST FALLS | ||||||||
| State: | ID | ||||||||
| PostalCode: | 838546251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5095404496 | ||||||||
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| Practice Location | |||||||||
| Address1: | 104 W 9TH AVE | ||||||||
| Address2: | |||||||||
| City: | POST FALLS | ||||||||
| State: | ID | ||||||||
| PostalCode: | 838549216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2087779740 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2022 | ||||||||
| LastUpdateDate: | 08/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | ID | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.