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Organization

LAKELAND PHYSICAL THERAPY AND SPORTS INJURIES P A

Active
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Organization

LAKELAND PHYSICAL THERAPY AND SPORTS INJURIES P A

Active
Other names
North Idaho Physical Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
SKY R PRUITT PT (PHYSICAL THERAPIST/OWNER)
(208) 687-9195
Entity
Organization

Contact information

Practice address
16658 N HIGHWAY 41, RATHDRUM, ID 83858-6890
(208) 687-9195
(844) 955-2492
Mailing address
16658 N HIGHWAY 41, RATHDRUM, ID 83858-6890
(208) 687-9195
(844) 955-2492

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002803500
ID
05
2803500
ID
Enumeration date
12/05/2007
Last updated
04/30/2025
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