| NPI | 1881938777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON WILLIAM BRUNS Physical Therapist 208-659-6327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: ID PT1877) |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2012-11-16 |