Organization
STREAMLINE SPORTS PHYSICAL THERAPY PC
Active
Organization
STREAMLINE SPORTS PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAIRE ZIKRATCH-CLAYSON PT (OWNER/PT)
(208) 269-2360
Entity
Organization
Contact information
Practice address
335 E LEWIS ST STE 10, POCATELLO, ID 83201-6408
(208) 269-2360
(208) 550-3256
Mailing address
335 E LEWIS ST STE 10, POCATELLO, ID 83201-6408
(208) 269-2360
(208) 550-3256
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2831
ID
Other
Enumeration date
08/08/2017
Last updated
09/20/2021
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