Organization
WILD ROSE PHYSIO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN JENTGES PT, DPT (OWNER)
(206) 948-7475
Entity
Organization
Contact information
Practice address
325 W PALOUSE RIVER DR, MOSCOW, ID 83843-8956
(208) 689-6044
(208) 242-4018
Mailing address
PO BOX 51, TROY, ID 83871-0051
(206) 948-7475
(208) 242-4018
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
06/04/2024
Last updated
06/04/2024
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