| NPI | 1881804169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOAH MILLER Owner President 208-539-4776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID RPT-1361) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2008-07-08 |