| NPI | 1295897213 |
|---|---|
| Doing Business As | MYOFASCIAL RELEASE CENTER OF IDAHO |
| Entity Type | Organization |
| Authorized Contact | LINDA ANN CHATBURN Ownermember 208-321-7831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2008-04-24 |