| NPI | 1427572957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED CLIFFORD PUGMIRE Owner/Physical Therapist 208-240-6017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID 5310) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2022-06-07 |