| NPI | 1790126522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN HULSEY President, CEO 208-288-1155 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT 2949) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2013-09-18 |