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Organization

BODY WISE PHYSICAL THERAPY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DOUGLAS WINSTON HOGGATT PT (MANAGER/DIRECTOR)
(208) 841-9900
Entity
Organization

Contact information

Practice address
2717 W BANNOCK ST STE 101, BOISE, ID 83702-4724
(208) 972-0572
(208) 639-2906
Mailing address
2717 W BANNOCK ST STE 101, BOISE, ID 83702-4724
(208) 972-0572
(208) 639-2906

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Enumeration date
01/20/2021
Last updated
09/29/2021
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