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Organization

62 DEGREES PHYSICAL THERAPY

Active
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Organization

62 DEGREES PHYSICAL THERAPY

Active
Other names
Myofascial Release Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KATRIN HURLEY MOFFETT PT, DPT, CWS, FACCWS (OWNER/MEMBER)
(208) 321-7831
Entity
Organization

Contact information

Practice address
8660 W EMERALD ST, BOISE, ID 83704-4825
(208) 321-7831
(208) 995-2870
Mailing address
8660 W EMERALD ST, BOISE, ID 83704-4825
(208) 321-7831
(208) 995-2870

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT632
ID

Other

Enumeration date
01/14/2014
Last updated
01/14/2014
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