| NPI | 1346127743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYREL SPENCER MILLER Owner 208-716-6602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2025-08-18 |
| Last Update Date | 2025-12-15 |