Organization
BK INC.
Active
Other names
Moscow Mountain Sport and Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ISAKSON PT (OWNER)
(208) 882-1426
Entity
Organization
Contact information
Practice address
872 TROY RD STE 180, MOSCOW, ID 83843-4046
(208) 882-1426
(208) 882-1428
Mailing address
872 TROY RD STE 180, MOSCOW, ID 83843-4046
(208) 882-1426
(208) 882-1428
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/08/2007
Last updated
08/17/2007
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