Organization
TETON PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL G GRIFFETH MPT (PRESIDENT)
(208) 529-3355
Entity
Organization
Contact information
Practice address
2037 E 17TH ST, IDAHO FALLS, ID 83404-6430
(208) 529-3355
(208) 529-9581
Mailing address
2037 E 17TH ST, IDAHO FALLS, ID 83404-6430
(208) 529-3355
(208) 529-9581
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT623
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002714400
—
ID
Enumeration date
02/26/2010
Last updated
07/21/2014
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