Organization
VISTA PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEEGAN DAVID PARMER DPT (OWNER)
(208) 529-1715
Entity
Organization
Contact information
Practice address
1615 MIDWAY DR, AMMON, ID 83406-6799
(208) 529-1715
Mailing address
233 S EMERY LN, IDAHO FALLS, ID 83401-4674
(208) 529-1715
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
03/01/2021
Last updated
04/02/2021
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