| NPI | 1124299045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY C. WILLIAMS Managing Member 208-735-8330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-1026) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-03-19 |