Organization
THERAPEUTIC ASSOCIATES INC
Active
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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