Organization
PINNACLE PHYSICAL THERAPY AND SPORTS MEDICINE, INC
Active
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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