Organization
CENTER FOR PHYSICAL REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY MCCULLY (MANAGER)
(208) 734-5313
Entity
Organization
Contact information
Practice address
754 N COLLEGE RD, SUITE D, TWIN FALLS, ID 83301-5822
(208) 734-5313
(208) 736-1582
Mailing address
754 N COLLEGE RD, SUITE D, TWIN FALLS, ID 83301-5822
(208) 734-5313
(208) 736-1582
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT-2561
ID
225100000X
Physical Therapist
RPT-1549
ID
225100000X
Physical Therapist
RPT-1620
ID
225100000X
Physical Therapist
Primary
RPT-208
ID
225100000X
Physical Therapist
RPT-267
ID
225100000X
Physical Therapist
RPT-432
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002620200
—
ID
Enumeration date
01/27/2006
Last updated
05/09/2014
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