Organization
IDAHO PHYSICAL THERAPY INC.
Active
Other names
Idaho PT Inc
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLIE MCCARTHY (VP ADMINISTRATION)
(208) 314-5904
Entity
Organization
Contact information
Practice address
2005 12TH AVE RD, NAMPA, ID 83686-6311
(208) 463-0022
(208) 463-0031
Mailing address
2005 12TH AVE RD, NAMPA, ID 83686-6311
(208) 463-0022
(208) 463-0031
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002689100
—
ID
Enumeration date
01/24/2007
Last updated
12/14/2022
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