| NPI | 1659540995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REID JACOB PATTERSON Physical Therapist 208-658-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID 2288) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-05-08 |