| NPI | 1184612772 |
|---|---|
| Doing Business As | HAILEY SPORT AND SPINE |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A MAZIK Owner 208-788-6312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID 1168) |
| Enumeration Date | 2005-10-08 |
| Last Update Date | 2020-08-22 |