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General NPI Number Information
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NPI Number | 1972686087
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Entity Type | Individual
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Provider Name | DARRELL EDWIN KRALL PT
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 01/27/2024
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Provider Practice Location Address
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Address Line | 2180 W IRONWOOD CENTER DR
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2639
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Country | US
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Telephone | 208-625-3680
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Fax | 208-625-3681
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Provider Business Mailing Address
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Address Line | 2180 W IRONWOOD CENTER DR
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2639
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Country | US
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Telephone | 208-625-3680
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Fax | 208-625-3681
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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 | PT00005703
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2251H1200X
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Taxonomy Name | Hand Physical Therapist
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License Number | PT-468
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-468
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License Number State | ID
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