Organization
FULL POTENTIAL PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAKER RAVEE MEDAVARAPU MPT (PHYSICAL THERAPIST)
(208) 816-8836
Entity
Organization
Contact information
Practice address
450 THAIN RD STE A, LEWISTON, ID 83501-5300
(208) 816-8836
(208) 621-2995
Mailing address
450 THAIN RD STE A, LEWISTON, ID 83501-5300
(208) 816-8836
(208) 746-0873
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT-1243
ID
Other
Enumeration date
02/26/2017
Last updated
11/29/2023
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