| NPI | 1548618804 |
|---|---|
| Doing Business As | LAKE POWELL PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | LEE JOHNSON Treasurer 208-401-1369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2019-10-31 |