Organization
TWIN FALLS PHYSICAL THERAPY AND WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY WILLIAMS RPT (PHYSICAL THERAPIST)
(208) 736-0887
Entity
Organization
Contact information
Practice address
812 SHOSHONE ST E, TWIN FALLS, ID 83301-6336
(208) 735-8563
Mailing address
PO BOX 1886, TWIN FALLS, ID 83303-1886
(208) 736-0887
(208) 736-0890
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010141847
REGENCE
ID
01
—
T9479
BLUE CROSS
ID
Enumeration date
08/23/2006
Last updated
08/22/2020
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