# POCATELLO REHABILITATION PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528143864
- **Authorized official:** MR. KEVIN S. HILL M.D. (PRESIDENT)
- **Authorized official phone:** (208) 234-1984

## Contact information

- **Practice address:** 500 S 11TH AVE STE 201, POCATELLO, ID 83201-4878
- **Practice address phone:** (208) 234-1984
- **Practice address fax:** (208) 234-1987
- **Mailing address:** 500 S 11TH AVE STE 201, POCATELLO, ID 83201-4878
- **Mailing address phone:** (208) 234-1984
- **Mailing address fax:** (208) 234-1987

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | M5852 | ID | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 08/22/2020