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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