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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