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1114170024
PRIMARY THERAPY SOURCE LLC
TWIN FALLS, ID
NPI
1114170024
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Entity Type
Organization
Authorized Contact
JAN YINGST
Owner
208-734-7333
Organization Subpart ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist
Enumeration Date
2008-10-23
Last Update Date
2008-10-23
Business Address
PRIMARY THERAPY SOURCE LLC
254 RIVER VISTA PL
TWIN FALLS, ID 83301-3006
Phone number: 208-734-7333
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Mailing Address
PRIMARY THERAPY SOURCE LLC
254 RIVER VISTA PL
TWIN FALLS, ID 83301-3006
Phone number: 208-734-7333
Copy
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