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General NPI Number Information
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NPI Number | 1740426196
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Entity Type | Individual
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Provider Name | JOHN WESLEY LINHART PT
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Gender | Male
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Dates
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Enumeration Date | 01/06/2009
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Last Update Date | 01/06/2009
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Provider Practice Location Address
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Address Line | 1116 NW 16TH STREET
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City | FRUITLAND
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State | ID
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Zip | 83619
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Country | US
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Telephone | 208-452-6505
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Fax |
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Provider Business Mailing Address
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Address Line | 509 W COBBLESTONE PL
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City | NAMPA
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State | ID
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Zip | 83651-2581
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Country | US
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Telephone | 208-467-1831
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5769
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 64
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License Number State | ID
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