Healthcare Provider Details

I. General information

NPI: 1487564316
Provider Name (Legal Business Name): ROBERT SBARCEA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1256 S RACKHAM WAY
MERIDIAN ID
83642-8816
US

IV. Provider business mailing address

5143 N YORGASON AVE
BOISE ID
83703-3273
US

V. Phone/Fax

Practice location:
  • Phone: 208-884-4647
  • Fax:
Mailing address:
  • Phone: 208-991-7828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5581929
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: