| NPI | 1427103837 |
|---|---|
| Former Legal Business Name | IDAHO PT INC |
| Entity Type | Organization |
| Authorized Contact | SHELLIE MCCARTHY VP Administration 208-314-5904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2022-12-14 |