Organization
ADVANCED PHYSICAL THERAPY & WOUND CENTER, PLLC
Active
Organization
ADVANCED PHYSICAL THERAPY & WOUND CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICIA SIDDOWAY P.T. (DIRECTOR OF THERAPY)
(208) 359-2500
Entity
Organization
Contact information
Practice address
1 PROFESSIONAL PLZ, REXBURG, ID 83440-2024
(208) 359-2500
(208) 359-2502
Mailing address
PO BOX 322, REXBURG, ID 83440-0322
(208) 359-2500
(208) 359-2502
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/09/2014
Last updated
06/11/2015
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