Healthcare Provider Details

I. General information

NPI: 1093407264
Provider Name (Legal Business Name): KIRSTEN MICHELLE ASH DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIRSTEN MICHELLE ROBINSON DPT

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

554 N STEELHEAD WAY STE 162
BOISE ID
83704-8388
US

IV. Provider business mailing address

1411 FALLS AVE E STE 401
TWIN FALLS ID
83301-3455
US

V. Phone/Fax

Practice location:
  • Phone: 208-323-9747
  • Fax: 208-323-9752
Mailing address:
  • Phone: 208-969-9945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8510
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: