| NPI | 1326024472 |
|---|---|
| Doing Business As | TAI BOISE PHYSICAL THERAPY STATE STREET |
| Entity Type | Organization |
| Authorized Contact | TODD ROBERT GIFFORD COO 503-443-6156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2012-10-26 |