Organization
EAGLE ROCK PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB B ROBERTS DPT (OWNER/PROVIDER)
(208) 521-7336
Entity
Organization
Contact information
Practice address
1542 ELK CREEK DR, SUITE B, IDAHO FALLS, ID 83404-8322
(208) 521-7336
Mailing address
1542 ELK CREEK DR, SUITE B, IDAHO FALLS, ID 83404-8322
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
02/26/2008
Last updated
02/26/2008
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