Organization
THERAPEUTIC ASSOCIATES INC
Active
Organization
THERAPEUTIC ASSOCIATES INC
Active
Other names
TAI SE Boise
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD ROBERT GIFFORD PT (INFORMATION SYSTEMS DIRECTOR)
(503) 443-6156
Entity
Organization
Contact information
Practice address
960 S BROADWAY AVE STE 200, BOISE, ID 83706-3600
(208) 433-9211
(208) 433-9241
Mailing address
16083 SW UPPER BOONES FERRY RD, STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 443-1402
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487630240
—
ID
05
—
1487630240-000
—
ID
01
—
197670349
OWCP
ID
05
—
197670349
—
ID
Enumeration date
12/22/2005
Last updated
05/06/2015
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