Organization
PRO-ACTIVE PHYSICAL THERAPY OF MCCALL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK J ZAK RPT (CEO/OWNER)
(208) 634-8517
Entity
Organization
Contact information
Practice address
319 DEINHARD LN, MCCALL, ID 83638-4703
(208) 634-8517
(208) 292-2817
Mailing address
P.O. BOX 2041, MCCALL, ID 83638
(208) 634-8517
(208) 634-5763
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805164900
—
ID
05
—
808054300
—
ID
Enumeration date
08/31/2006
Last updated
03/13/2020
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