| NPI | 1689770711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAVIN MCEACHERN MORRISON Member / Manager 208-336-1042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist Orthopedic (Licence: ID PT-1516) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-08-22 |