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General NPI Number Information
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NPI Number | 1326349846
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Entity Type | Individual
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Provider Name | RANDY HIL M.T.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 421 W 2ND S
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City | SODA SPRINGS
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State | ID
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Zip | 83276-5006
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Country | US
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Telephone | 208-547-4404
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Fax | 208-547-3575
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Provider Business Mailing Address
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Address Line | 421 W 2ND S
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City | SODA SPRINGS
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State | ID
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Zip | 83276-5006
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Country | US
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Telephone | 208-547-4404
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Fax | 208-547-3575
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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 | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number |
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License Number State | ID
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