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Organization
ATLAS BRACING LLC
Active
Organization
ATLAS BRACING LLC
Active
Parent organization
STREAMLINE SPORTS PHYSICAL THERAPY PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
STREAMLINE SPORTS PHYSICAL THERAPY PC
Authorized official
DEBORAH A GOSS (CREDENTIALING)
(208) 221-1161
Entity
Organization
Contact information
Practice address
4133 N GARTON LN, POCATELLO, ID 83204-7102
(208) 244-7751
(208) 550-3256
Mailing address
4133 N GARTON LN, POCATELLO, ID 83204-7102
(208) 244-7751
(208) 550-3256
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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