Kane, Justin Thomas

Kane, Justin Thomas is an individual health care provider with primary practice located at 1172 W Hayden Ave , Hayden ID 83835-8700. 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. Kane, Justin Thomas can be contacted via phone (208) 762-3332.

Contact Information

Primary practice address
1172 W Hayden Ave Hayden ID 83835-8700
Phone: (208) 762-3332
Fax: (208) 762-4268
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT-700 Idaho

Profile Details

NPI number 1114957073
LBN Legal business name Kane, Justin Thomas
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated Mar 6th, 2009 - about 16 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 1114957073 NPPES
Idaho Other 0000100007419 BLUE SHIELD
Idaho Other 0100472 BLUE SHIELD
Idaho MEDICAID 004401801 BLUE SHIELD
Idaho Other T5501 BLUE SHIELD

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