| NPI | 1073718391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY KENNELLY Corporate Compliance Manager 208-245-4576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP-1123) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: ID OT-510) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: ID OT-061) | |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: ID PT-160) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2025-09-11 |