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Organization
TRI-CITY PHYSICAL THERAPY, P.C.
Active
Organization
TRI-CITY PHYSICAL THERAPY, P.C.
Active
Other names
Advanced Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CODY DEE STEPHENS P.T. (OWNER/PRESIDENT)
(208) 452-6366
Entity
Organization
Contact information
Practice address
275 E 7TH ST, WEISER, ID 83672-2303
(208) 549-1008
(208) 549-1396
Mailing address
275 E 7TH ST, WEISER, ID 83672-2303
(208) 549-1008
(208) 549-1396
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NULL
174400000X
Specialist
Primary
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804093200
—
ID
Enumeration date
07/20/2006
Last updated
05/21/2013
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