Organization
MOBLEY PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY ERROL MOBLEY MSPT (OWNER/PHYSICAL THERAPIST)
(208) 745-8332
Entity
Organization
Contact information
Practice address
151 E MAIN ST, RIGBY, ID 83442-1417
(208) 745-8332
(208) 745-8272
Mailing address
151 E MAIN ST, RIGBY, ID 83442-1417
(208) 745-8332
(208) 745-8272
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
RPT895
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136534
MEDICARE PART A
ID
05
—
805445700
—
ID
Enumeration date
01/17/2008
Last updated
09/29/2010
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