Godderidge, Alex Charles

Godderidge, Alex Charles is an individual health care provider with primary practice located at 12072 W Mcmillan Rd , Boise ID 83713-2462. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Godderidge, Alex Charles can be contacted via phone (208) 939-0533.

Contact Information

Primary practice address
12072 W Mcmillan Rd Boise ID 83713-2462
Phone: (208) 939-0533
Fax: (208) 939-3341
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT-7679 Idaho

Profile Details

NPI number 1942951736
LBN Legal business name Godderidge, Alex Charles
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2022
Last updated Dec 1st, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942951736 NPPES
Idaho Other PT-7679 STATE LICENSE

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