Organization
SUPERIOR PHYSICAL THERAPY
Active
Organization
SUPERIOR PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILIE L PETERSON DPT (PHYSICAL THERAPIST)
(208) 570-3636
Entity
Organization
Contact information
Practice address
1800 FLANDRO DR STE 190, POCATELLO, ID 83202-4940
(208) 233-2248
(208) 233-0219
Mailing address
1800 FLANDRO DR STE 190, POCATELLO, ID 83202-4940
(208) 233-2248
(208) 233-0219
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3602
ID
Other
Enumeration date
05/28/2014
Last updated
06/09/2014
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