MEDICARE: MRS. VICTORIA ZUMBERGE CAIN PT, CWS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	1171893	TX
2	2251P0200X	Pediatric Physical Therapist	2568	AK
3	225100000X	Physical Therapist	PT-4034	ID

General Provider Information

NPI Number	:	1265635684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VICTORIA ZUMBERGE CAIN PT, CWS

Provider Business Mailing Address
First Line	:	3715 WOODKING DR
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-4720
Country	:	US
Telephone Number	:	208-529-2255
Fax Number	:	208-529-2022

Provider Business Practice Location Address
First Line	:	3715 WOODKING DR
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-4720
Country	:	US
Telephone Number	:	208-529-2255
Fax Number	:	208-529-2022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	03/23/2025

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