| NPI | 1952543803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL A GRAGERT Director 208-841-7457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2009-03-24 |