Organization
PROACTIVE PHYSICAL THERAPY OF MCCALL, PA
Active
Parent organization
PROACTIVE PHYSICAL THERAPY OF MCCALL, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROACTIVE PHYSICAL THERAPY OF MCCALL, PA
Authorized official
MOIRA J STOTLER (BILLING SPECIALIST)
(208) 634-8517
Entity
Organization
Contact information
Practice address
101 N COUNCIL AVENUE, SUITE A, COUNCIL, ID 83612-0000
(208) 253-6893
Mailing address
PO BOX 2041, MCCALL, ID 83638-2041
(208) 634-8517
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
ID
Other
Enumeration date
05/01/2008
Last updated
05/01/2008
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