Organization
GOOD LIFE PHYSICAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMA NELSON PT, DPT (PHYSICAL THERAPIST)
(208) 739-5145
Entity
Organization
Contact information
Practice address
804 N WHITLEY DR, FRUITLAND, ID 83619-2437
(208) 740-3549
Mailing address
1919 3RD AVE S, PAYETTE, ID 83661-3011
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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