| NPI | 1134149941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISH ORTEGA Office Manager 208-777-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2018-07-18 |