| NPI | 1639229115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN COYNE President, Owner 208-726-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: ID PT-332) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2012-06-26 |