Organization
JUMP START PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLISON SANDERS PT (OWNER / PHYSICAL THERAPIST)
(208) 664-2468
Entity
Organization
Contact information
Practice address
411 W HAYCRAFT AVE, STE B3, COEUR D ALENE, ID 83815-8105
(208) 664-2468
(208) 667-6239
Mailing address
411 W HAYCRAFT AVE, STE B3, COEUR D ALENE, ID 83815-8105
(208) 664-2468
(208) 667-6239
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT-2061
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010164610
REGENCE BLUE SHIELD
—
05
—
807908300
—
ID
01
—
TD687
BLUE CROSS OF IDAHO
—
Enumeration date
04/21/2008
Last updated
01/30/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us