| NPI | 1497143507 |
|---|---|
| Doing Business As | FUNCTIONAL PHYSICAL THERAPY CENTER |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER J HANSEN Owner 208-760-9988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: ID PT-2832) |
| Enumeration Date | 2014-12-26 |
| Last Update Date | 2015-01-21 |