| NPI | 1245415751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN L WEATHERLY President 208-542-0066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-1801) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2008-04-11 |