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General NPI Number Information
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NPI Number | 1588244289
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Entity Type | Individual
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Provider Name | CAYLEE MARIE SKOGLUND DPT
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Gender | Female
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 904 S VANGUARD WAY STE 110
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City | MERIDIAN
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State | ID
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Zip | 83642-7552
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Country | US
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Telephone | 208-803-6767
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Fax | 208-803-6766
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Provider Business Mailing Address
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Address Line | 645 E STATE ST STE 101
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City | EAGLE
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State | ID
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Zip | 83616-5915
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Country | US
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Telephone | 208-939-9594
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Fax | 208-939-9828
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | ID
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