Healthcare Provider Details

I. General information

NPI: 1205769775
Provider Name (Legal Business Name): JOSHUA GUINTER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S BRIDGEWAY PL
EAGLE ID
83616-6099
US

IV. Provider business mailing address

1001 S BRIDGEWAY PL
EAGLE ID
83616-6099
US

V. Phone/Fax

Practice location:
  • Phone: 208-385-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6481515
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: