Organization
FLICKER PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY A FLICKER PT (OWNER)
(208) 406-2057
Entity
Organization
Contact information
Practice address
4922 YELLOWSTONE AVE STE J, CHUBBUCK, ID 83202-2360
(208) 237-1882
(208) 904-2990
Mailing address
2839 MARGO LN, POCATELLO, ID 83201-1961
(208) 406-2057
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/29/2011
Last updated
12/31/2014
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