Organization
SHELLMAN INC PA
Active
Other names
North Idaho Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TESS ROGERS (OFFICE MANAGER)
(208) 664-8194
Entity
Organization
Contact information
Practice address
1917 N LAKEWOOD DR, COEUR D ALENE, ID 83814-2634
(208) 664-8194
(208) 667-1847
Mailing address
1917 N LAKEWOOD DR, COEUR D ALENE, ID 83814-2634
(208) 664-8194
(208) 667-1847
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
MULTIPLE PROVIDERS
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002778800
—
ID
01
—
0051780
GROUP PROVIDER NUMBER
WA
Enumeration date
08/12/2006
Last updated
03/06/2009
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