Organization
MYOFASCIAL RELEASE TREATMENT CENTER OF IDAHO LLC
Active
Other names
MYOFASCIAL RELEASE CENTER OF IDAHO
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA ANN CHATBURN PTA (OWNERMEMBER)
(208) 321-7831
Entity
Organization
Contact information
Practice address
1556 S TIMESQUARE LN, BOISE, ID 83709-8269
(208) 321-7831
(208) 323-7651
Mailing address
1556 S TIMESQUARE LN, BOISE, ID 83709-8269
(208) 321-7831
(208) 323-7651
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
12/15/2006
Last updated
04/24/2008
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