| NPI | 1992975825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY BOYD RAWLINGS Physical Therapist 208-359-6127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: ID 1346) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2013-03-12 |