Healthcare Provider Details

I. General information

NPI: 1215905468
Provider Name (Legal Business Name): NORMAN L TOEWS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: N LARRY TOEWS PT

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 11/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 W HUBBARD ST STE 122
COEUR D ALENE ID
83814-2285
US

IV. Provider business mailing address

610 HUBBARD AVE STE 122
COEUR D ALENE ID
83814
US

V. Phone/Fax

Practice location:
  • Phone: 208-667-3583
  • Fax: 208-667-2643
Mailing address:
  • Phone: 208-667-3583
  • Fax: 208-667-2643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 103
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 00002784
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501000724
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: