Organization
PHYSICAL THERAPY SPECIALISTS OF IDAHO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY LAYNE RASMUSSEN (OWNER)
(208) 478-1488
Entity
Organization
Contact information
Practice address
2240 E CENTER ST, SUITE D, POCATELLO, ID 83201-2600
(208) 478-1488
Mailing address
675 YELLOWSTONE AVE STE 1A, POCATELLO, ID 83201-4511
(208) 478-1488
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2070
ID
Other
Enumeration date
11/01/2013
Last updated
09/19/2025
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