Organization
EVERGREEN PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY C WILLIAMS RPT (OWNER)
(208) 736-0887
Entity
Organization
Contact information
Practice address
491 CASWELL AVE W, TWIN FALLS, ID 83301-3743
(208) 736-0887
(208) 736-0890
Mailing address
PO BOX 1886, TWIN FALLS, ID 83303-1886
(208) 736-0887
(208) 736-0890
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1026
ID
Other
Enumeration date
12/12/2008
Last updated
02/18/2009
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