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Contact Information

LEO E ROBERTSON III, PT
134 S STATE ST
PRESTON, ID83263
 Phone: 208-852-4122
 Fax: 208-852-7187
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for LEO E ROBERTSON III · (Male)

NPI # 1346465887
Status Active
Credentials PT (Physical Therapist)
Entity Individual
Enumeration date 04/17/2007
Last updated 07/05/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • ID License # PT-2026
  • ID Medicaid 1346465887
  • UT Medicaid D5960
  • ID Other PT-2026 PHYSICAL THERAPY LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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