| NPI | 1669530051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY GREENWELL Office Manager 208-678-1191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 261QH0700X Clinic/Center Hearing and Speech |
| 261QX0100X Clinic/Center Occupational Medicine | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2018-06-21 |