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Derek Roberts, LMT
NPI 1417776345 · on the registry since 2024
Practice
- Address
- 3046 S Bown Way Ste A
Boise, ID 83706 - Phone
- (208) 318-6561
- Organisation at this address
- Mangum Primary Care Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 225700000X
225700000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-10-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho