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Organization

RENEW MANUAL PHYSICAL THERAPY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BREANN FAYE SUDDOCK FOX PT, DPT, PRPC (OWNER/THERAPIST)
(602) 515-6659
Entity
Organization

Contact information

Practice address
7444 W SAXTON DR # K101, BOISE, ID 83714-1316
(602) 515-6659
Mailing address
7444 W SAXTON DR # K101, BOISE, ID 83714-1316
(602) 515-6659

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-5245
ID

Other

Enumeration date
09/14/2017
Last updated
07/21/2022
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