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Organization
BEYOND REHAB
Active
Organization
BEYOND REHAB
Active
Other names
Neuro Clinic Idaho
Organization subpart
No
Provider details
NPI number
Authorized official
ARIEL PODJUN OTR/L (OCCUPATIONAL THERAPIST)
(307) 389-7509
Entity
Organization
Contact information
Practice address
10122 IRONGATE DR, NAMPA, ID 83687-7920
(307) 389-7509
Mailing address
10122 IRONGATE DR, NAMPA, ID 83687-7920
(307) 389-7509
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
2251N0400X
Neurology Physical Therapist
—
NULL
2251N0400X
Neurology Physical Therapist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
—
NULL
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/21/2024
Last updated
11/24/2024
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