| NPI | 1265524045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI L KOTH Its Secretary/Treasurer, Its Bus Mg 208-788-3997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2014-01-21 |