| NPI | 1457741415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRETT J GIBSON Physical Therapist / Owner 208-709-6053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-3069) |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2018-05-02 |