Idaho Pediatric Therapy Clinic Pllc

NPI 1194125617 - Physical Therapist - 225100000X

NPI Details
NPI 1194125617
Enumeration Date 09/03/2014
Last Updated 01/02/2015
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name ROBERT ROBERT
Position MANAGER
Phone (208) 939-3334
Fax (208) 939-3341
Practice Location
13895 W WAINWRIGHT DR
BOISE ID, 83713-5011, US
Phone (208) 939-3334
Fax (208) 939-3341
Business Location
13895 W WAINWRIGHT DR
BOISE ID, 83713-5011, US
Phone (208) 939-3334
Fax (208) 939-3341
Toxanomy
Taxonomy Code 225100000X
License State Idaho
License Number PT-1450
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According to our database, Idaho Pediatric Therapy Clinic Pllc NPI is 1194125617, taxonomy code is 225100000X and license number is PT-1450, license state is located at Idaho. Idaho Pediatric Therapy Clinic Pllc physically located at 13895 W Wainwright Dr, Boise ID, 83713-5011. NPI Number 1033115704 has the healthcare provider type.

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1194125617 NPI number is provided on an as is basis without warranty of any kind. 1194125617 is maintained by the National Plan & Provider Enumeration System. The contents of Idaho Pediatric Therapy Clinic Pllc are for informational purposes only.