| NPI | 1154911493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS WINSTON HOGGATT Manager/Director 208-841-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2021-09-29 |