Organization
THERAPEUTIC ASSOCIATES INC
Active
Other names
TAI Boise Physical Therapy State Street
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD ROBERT GIFFORD PT (COO)
(503) 443-6156
Entity
Organization
Contact information
Practice address
390 E PARKCENTER BLVD, SUITE 130, BOISE, ID 83706-6662
(208) 433-9211
(208) 433-9241
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326024472
—
ID
05
—
1326024472-000
—
ID
05
—
197670348
—
ID
Enumeration date
12/21/2005
Last updated
10/26/2012
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