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Organization
RENAISSANCE REHAB
Active
Organization
RENAISSANCE REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES A KING MS, OTR/L (OWNER)
(208) 339-7234
Entity
Organization
Contact information
Practice address
4846 WIND RIVER RD, IDAHO FALLS, ID 83401-5828
(208) 339-7234
(208) 552-0395
Mailing address
4846 WIND RIVER RD, IDAHO FALLS, ID 83401-5828
(208) 339-7234
(208) 552-0395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT-1398
ID
225X00000X
Occupational Therapist
Primary
OT-843
ID
Other
Enumeration date
09/27/2014
Last updated
09/27/2014
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