Organization
IDAHO FAMILY PHYSICAL THERAPY PLLC
Active
Other names
Idaho Family PT
Organization subpart
No
Provider details
NPI number
Authorized official
CONNOR TODD BROWN PT, DPT, CERTDN (OWNER)
(425) 375-8991
Entity
Organization
Contact information
Practice address
2422 12TH AVE RD, NAMPA, ID 83686-6300
(425) 375-8991
Mailing address
833 CHICAGO ST, NAMPA, ID 83686-7301
(208) 466-0566
(208) 697-5213
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235713090
—
ID
Enumeration date
12/09/2022
Last updated
02/13/2023
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