Healthcare Provider Details

I. General information

NPI: 1629813951
Provider Name (Legal Business Name): CAIN BOSCHEE PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 S BECK RD STE 2
POST FALLS ID
83854-4890
US

IV. Provider business mailing address

463 WESTFIELD BLVD APT 726
TEMPLE TX
76502-5322
US

V. Phone/Fax

Practice location:
  • Phone: 208-408-0484
  • Fax: 509-891-5591
Mailing address:
  • Phone: 406-407-1207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4271595
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: