Lon M. Egbert, P.c.

NPI #1265527725 in Jerome, Idaho

Provider Information

NPI Number: 1265527725
Entity Type: Organization
Organization Name: Lon M. Egbert, P.c.
Primary Specialty: Physical Therapist
Enumeration Date: Oct 3, 2006
Last Updated: Jan 15, 2010

Practice Location

Address: 128 5TH AVE WEST
City: Jerome
State: Idaho
ZIP Code: 83338
Phone: (208) 324-3090

Authorized Official

Name: MR. LON M EGBERT, PT, ATC
Title: PRESIDENT OWNER
Phone: (208) 324-3090

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Physical Therapist	225100000X	Primary

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