Healthcare Provider Details

I. General information

NPI: 1497529333
Provider Name (Legal Business Name): ASHLYN MARIE ZOON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2023
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 CENTER ST W STE C
KIMBERLY ID
83341-5326
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 208-423-9999
  • Fax: 208-423-9998
Mailing address:
  • Phone: 208-736-2574
  • Fax: 208-736-2594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-8730
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: