| NPI | 1164850947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLIE M MCCARTHY Vice President 208-375-0666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT538) |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2014-03-29 |