| NPI | 1881118941 |
|---|---|
| Doing Business As | STAFFORD PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | DAREN A STAFFORD Owner/Provider 208-991-8487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: ID PT-2466) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2022-07-21 |