| NPI | 1801944400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T BATES President 208-232-4267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID PT-1730) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: ID PT-2487) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2009-12-09 |