Organization
S.P.O.R.T. PHYSICAL THERAPY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY A. STEIGER (OWNER/MANAGER)
(208) 746-0214
Entity
Organization
Contact information
Practice address
3506 12TH ST, LEWISTON, ID 83501-5511
(208) 746-0214
(208) 746-0948
Mailing address
3506 12TH ST, LEWISTON, ID 83501-5511
(208) 746-0214
(208) 746-0948
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806463300
—
ID
Enumeration date
07/14/2017
Last updated
07/06/2021
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