| NPI | 1013206002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD D MILLER President 208-340-5099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: ID PT 1938) |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2020-06-11 |