| NPI | 1063218444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH G FISCHER Owner 208-297-1570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225700000X Massage Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-02-24 |