Provider Demographics
NPI:1679822423
Name:BOOK, ANTHONY RAY (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:RAY
Last Name:BOOK
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 E ALTA RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-7120
Mailing Address - Country:US
Mailing Address - Phone:208-890-4681
Mailing Address - Fax:
Practice Address - Street 1:2707 GARRITY BLVD
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-3674
Practice Address - Country:US
Practice Address - Phone:208-442-2329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-3052225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist