NPI | 1215381181 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAWN ROBERT HIGBEE Owner 208-242-8617 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: ID PT-3095) |
Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
Enumeration Date | 2016-04-18 |
Last Update Date | 2019-10-29 |