Organization
SANDPOINT PHYSICAL THERAPY & AQUATIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUDOLF KREPS LPT (CEO)
(208) 263-8866
Entity
Organization
Contact information
Practice address
1301 N DIVISION AVE, SANDPOINT, ID 83864-8268
(208) 263-8866
Mailing address
1301 N DIVISION AVE, SANDPOINT, ID 83864-8268
(208) 263-8866
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T9818
BLUE CROSS GROUP PROVIDER
ID
Enumeration date
08/09/2006
Last updated
08/22/2020
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