Mix, M Andrew

Mix, M Andrew is an sole proprietor health care provider with primary practice located at 276 Eastland Dr N , Twin Falls ID 83301-4458. 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. Mix, M Andrew can be contacted via phone (208) 735-8563.

Contact Information

Primary practice address
276 Eastland Dr N Twin Falls ID 83301-4458
Phone: (208) 735-8563
Fax: (208) 735-8564
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT-1352 Idaho

Profile Details

NPI number 1346205937
LBN Legal business name Mix, M Andrew
Credentials Registered Physical Therapist (RPT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 18th, 2006
Last updated Nov 24th, 2015 - about 10 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 1346205937 NPPES
Idaho Other 000010141846 REGENCE
Idaho MEDICAID 806571300 REGENCE
Idaho Other T7275 REGENCE
Idaho MEDICAID 806555000 REGENCE
Idaho Other P00045805 REGENCE

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