| NPI | 1548699465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY LAYNE RASMUSSEN Owner 208-478-1488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-2070) |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2025-09-19 |