Organization
I CAN PT LLC
Active
Other names
I CAN PT Doctors of Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER J HENDERSON DPT (CEO)
(208) 789-0200
Entity
Organization
Contact information
Practice address
1626 WELLS AVE, SUITE 105, MERIDIAN, ID 83642-4524
(208) 789-0200
(208) 288-2784
Mailing address
1626 WELLS AVE, SUITE 105, MERIDIAN, ID 83642-4524
(208) 789-0200
(208) 288-2784
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2550
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194129817
GROUP NPI
ID
Enumeration date
10/09/2014
Last updated
02/06/2015
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