Organization
METTA PHYSICAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE LORAINE DPT, OMS (OWNER)
(208) 946-5364
Entity
Organization
Contact information
Practice address
210 TRIANGLE DR STE E, PONDERAY, ID 83852-9791
(208) 946-5364
(208) 946-5364
Mailing address
210 TRIANGLE DRIVE, SUITE E, PONDERAY, ID 83852-9791
(208) 946-5364
(208) 946-5364
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/21/2022
Last updated
12/07/2022
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