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General NPI Number Information
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NPI Number | 1013136407
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Entity Type | Individual
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Provider Name | JOSEPH THORNTON LMPO
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 801 BRYDEN AVE
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City | LEWISTON
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State | ID
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Zip | 83501-4927
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Country | US
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Telephone | 208-798-4605
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2620
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City | HAYDEN
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State | ID
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Zip | 83835-2620
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Country | US
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Telephone | 208-676-9080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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