| NPI | 1023381472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN SPIEGEL Member Owner 208-629-8927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: ID PT-2559) |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2013-10-04 |