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Contact Information

MARY VANORDEN, CPT
1246 YELLOWSTONE AVE STE F2
POCATELLO, ID83201-4372
 Phone: 208-904-1270
 Fax: 208-904-1270
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist/Technologist

225500000X
 

Physical Therapy Assistant

225200000X
Indicates primary specialty

NPI Profile & details for MARY VANORDEN · (Female)

NPI Number 1356742613
Status Active
Credentials CPT
Entity Individual
Enumeration date 09/05/2014
Last updated 09/05/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • ID License # PTA-368
  • ID License # T178488
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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