| NPI | 1568323772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICAH DEAN WEBER Owner/Physical Therapist 208-220-1105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2025-11-19 |
| Last Update Date | 2026-01-28 |