| NPI | 1295234367 |
|---|---|
| Doing Business As | PERFORMANCE PHYSICAL THERAPY OF IDAHO |
| Entity Type | Organization |
| Authorized Contact | MATTHEW CANDAU CEO 925-856-7007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2023-02-27 |