| NPI | 1265527725 |
|---|---|
| Doing Business As | JEROME PHYSICAL THERAPY & SPORTS MEDICINE CLINIC |
| Entity Type | Organization |
| Authorized Contact | LON M EGBERT President Owner 208-324-3090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID pt-1686) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: ID pending) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-01-15 |