| NPI | 1265844062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILIE L PETERSON Physical Therapist 208-570-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-3602) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2014-06-09 |