| NPI | 1992690101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS GARDNER Owner, Physical Therapist 208-613-7361 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 2251P0200X Physical Therapist, Pediatrics | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2025-06-09 |
| Last Update Date | 2025-06-24 |