Organization
IDAHO DIRECT PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYLER J BURKE DPT (OWNER)
(815) 545-3996
Entity
Organization
Contact information
Practice address
1559 N STEVENS DR APT B, IDAHO FALLS, ID 83401-3947
(815) 545-3996
Mailing address
1559 N STEVENS DR APT B, IDAHO FALLS, ID 83401-3947
(815) 545-3996
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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