| NPI | 1982203030 |
|---|---|
| Doing Business As | CHANNING PHYSICAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | ADAM BALMFORTH LLC Member 208-529-8005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |