Organization
LAKEWOOD PHYSICAL THERAPY LLC
Active
Parent organization
NORTH IDAHO FAMILY PHYSICIANS
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH IDAHO FAMILY PHYSICIANS
Authorized official
ERIC KOELSCH (EXECUTIVE DIRECTOR)
(208) 676-0145
Entity
Organization
Contact information
Practice address
1401 LINCOLN WAY, COEUR D ALENE, ID 83814-2334
(208) 676-1424
Mailing address
700 W IRONWOOD DR, SUITE 272E, COEUR D ALENE, ID 83814-2656
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG9013
RAILROAD MEDICARE
ID
Enumeration date
11/22/2006
Last updated
10/16/2009
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