| NPI | 1093253940 |
|---|---|
| Doing Business As | LAKE COUNTRY PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | SHAWNA E BENNER-ERICKSON Owner/Physical Therapist 208-263-1632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-1783) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2017-02-10 |