| NPI | 1548321557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN R JOHNSON Owner 208-571-6739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: ID PT178) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |