| NPI | 1073038378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAIRE ZIKRATCH-CLAYSON Owner/PT 208-269-2360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-2831) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2021-09-20 |