Organization
PT MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN BIRD (MANAGING MEMBER)
(630) 364-8144
Entity
Organization
Contact information
Practice address
490 MEMORIAL DR, IDAHO FALLS, ID 83402-3656
(630) 364-8144
(866) 661-4322
Mailing address
PO BOX 51630, IDAHO FALLS, ID 83405-1630
(630) 364-8144
(866) 661-4322
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/17/2013
Last updated
04/17/2013
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