Organization
PRIMARY THERAPY SOURCE LLC
Active
Organization
PRIMARY THERAPY SOURCE LLC
Active
Other names
PrimaryTherapySource LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH JAN YINGST PT (MANAGING MEMBER)
(208) 734-7333
Entity
Organization
Contact information
Practice address
254 RIVER VISTA PL, TWIN FALLS, ID 83301-3006
(208) 734-7333
(208) 734-8350
Mailing address
254 RIVER VISTA PL, TWIN FALLS, ID 83301-3006
(208) 734-7333
(208) 734-8350
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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