Most Relevant Information
Provider Data
| NPI Number: | 1003382276 |
| Provider Name: | JOEL CRUZ PT |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | PTA-4520 |
Most Important Dates
| Enumeration Date: | 10/16/2018 |
| Last Updated: | 04/22/2024 |
Provider Practice Location
186 W PINE ST
SHELLEY
ID
832741235
Practice Location Phone/Fax
| Phone: | 2086804787 |
| Fax: |
Provider Mailing Location
400 GRANT ST
BLACKFOOT
ID
832212119
Provider Mailing Phone/Fax
| Phone: | 2086804787 |
| Fax: |