Most Relevant Information
Provider Data
| NPI Number: | 1003439761 |
| Provider Name: | REBECCA SUE WARNKE ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/28/2020 |
| Last Updated: | 05/28/2020 |
Provider Practice Location
3125 VALENCIA DR
IDAHO FALLS
ID
834047575
Practice Location Phone/Fax
| Phone: | 2085293332 |
| Fax: |
Provider Mailing Location
4172 E NIBLEY CIR
IDAHO FALLS
ID
834013781
Provider Mailing Phone/Fax
| Phone: | 9062819852 |
| Fax: |