Provider Demographics
NPI:1700626579
Name:ESSIG, THOMAS WHITNEY (DPT, PT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:WHITNEY
Last Name:ESSIG
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:90 E USTICK RD STE 150
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-6462
Mailing Address - Country:US
Mailing Address - Phone:208-467-4357
Mailing Address - Fax:208-467-4395
Practice Address - Street 1:1015 12TH AVE S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-4660
Practice Address - Country:US
Practice Address - Phone:208-467-4357
Practice Address - Fax:208-467-4395
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-9187225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist