Organization
POCATELLO PHYSICAL THERAPY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN R DES FOSSES PT (PRESIDENT OWNER)
(208) 233-4800
Entity
Organization
Contact information
Practice address
1033 W QUINN RD, POCATELLO, ID 83202-2425
(208) 233-4800
(208) 233-4887
Mailing address
PO BOX 2844, POCATELLO, ID 83206-2844
(208) 233-4800
(208) 233-4887
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010026861
BLUE SHIELD
ID
05
—
002463600
—
ID
01
—
T0296
BLUE CROSS
ID
Enumeration date
10/23/2006
Last updated
05/10/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us