Organization
BUILDING BLOCKS PEDIATRIC THERAPY
Active
Organization
BUILDING BLOCKS PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE L LARSEN DPT (OWNER/PHYSICAL THERAPIST)
(208) 816-4195
Entity
Organization
Contact information
Practice address
1019 3RD ST, LEWISTON, ID 83501-2713
(208) 818-4846
Mailing address
1019 3RD ST, LEWISTON, ID 83501-2713
(208) 818-4846
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
PT000010795
WA
2251P0200X
Pediatric Physical Therapist
Primary
PT2265
ID
Other
Enumeration date
02/17/2014
Last updated
04/12/2014
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