| NPI | 1225235039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARYL DEAN MAYES Owner 208-644-1433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: ID 125) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2013-05-28 |