Organization
MOUNTAIN WEST SPORT AND SPINE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH CAPPETTO PTA (OWNER/CLINIC MANAGER)
(253) 334-0178
Entity
Organization
Contact information
Practice address
649 N CLIFF CREEK LN, MERIDIAN, ID 83642-1071
(253) 334-0178
Mailing address
1826 N HENDERSON AVE, MERIDIAN, ID 83646-6466
(253) 334-0178
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
07/11/2024
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