| NPI | 1700128337 |
|---|---|
| Former Legal Business Name | HYDE ELLIS PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | JASON R HYDE Physicals Therapist/Owner 208-227-6255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: ID PT-1987) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2013-09-13 |