| NPI | 1578076519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT PIERCE Owner, Physical Therapist 208-371-2610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-3309) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2018-03-13 |