| NPI | 1568980985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS LOUGHEED PT/Director 208-473-2717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-3215) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2022-07-21 |