Healthcare Provider Details

I. General information

NPI: 1881508141
Provider Name (Legal Business Name): LUCAS THORNE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 E PLAZA DR
EAGLE ID
83616-6548
US

IV. Provider business mailing address

694 N MUDSTONE WAY
KUNA ID
83634-2452
US

V. Phone/Fax

Practice location:
  • Phone: 208-939-0886
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8581928
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: