Organization
INSTITUTE OF PHYSICAL THERAPY AND FITNESS
Active
Organization
INSTITUTE OF PHYSICAL THERAPY AND FITNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PEGGY E OHMAN (BUSINESS MANAGER)
(208) 746-1418
Entity
Organization
Contact information
Practice address
678 SOUTHWAY AVE, LEWISTON, ID 83501-3783
(208) 746-1418
(208) 746-4123
Mailing address
678 SOUTHWAY AVE, LEWISTON, ID 83501-3783
(208) 746-1418
(208) 746-4123
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0112038
WA LI
ID
01
—
1000927
CHAMPUS/BLUE CROSS
ID
01
—
390090
REGENCE GROUP
ID
01
—
650006220
RR MEDICARE
ID
01
—
7023864
WAPA GROUP
ID
01
—
8B263
BCID GROUP
ID
Enumeration date
10/19/2006
Last updated
10/19/2011
Update your record
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