| NPI | 1902098841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI L SCOTT Owner 208-317-2371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: ID PT1078) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2007-08-14 |