Organization
PINNACLE PHYSICAL THERAPY AND SPORTS MEDICINE, INC
Active
Other names
Summit Rehabilitation Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK B BENGTSON M.P.T. (OWNER)
(208) 777-4242
Entity
Organization
Contact information
Practice address
1590 E POLSTON AVE, SUITE B, POST FALLS, ID 83854-5218
(208) 777-4242
(208) 777-4020
Mailing address
1590 E POLSTON AVE, SUITE B, POST FALLS, ID 83854-5218
(208) 777-4242
(208) 777-4020
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010160541
REGENCE BLUESHIELD
ID
01
—
T9333
BLUE CROSS
ID
Enumeration date
03/14/2007
Last updated
09/11/2007
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