Organization
ASPIRE PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORIA GOULD GUNTER MPT (OWNER/PHYSICAL THERAPIST)
(208) 720-3421
Entity
Organization
Contact information
Practice address
113 E BULLION ST, SUITE C, HAILEY, ID 83333-8770
(208) 720-3421
(208) 297-2680
Mailing address
PO BOX 92, HAILEY, ID 83333-0092
(208) 720-3421
(208) 297-2680
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010030447
BLUE SHIELD
ID
05
—
1275512246
—
ID
01
—
T4868
BLUE CROSS
ID
Enumeration date
01/18/2017
Last updated
01/18/2017
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