Organization
GEM REHABILITATION SERVICES, INC.
Active
Other names
Payette River Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GAYLE FRY (OFFICE MANAGER)
(208) 793-3333
Entity
Organization
Contact information
Practice address
400 HIGHWAY 55 STE A, SUITE B, HORSESHOE BEND, ID 83629-9016
(208) 793-3333
(208) 793-6333
Mailing address
PO BOX 205, HORSESHOE BEND, ID 83629-0205
(208) 793-3333
(208) 621-0234
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010007267
BLUE SHIELD OF IDAHO GROU
ID
05
—
002636700
—
ID
01
—
124160
WASH. STATE DEPT OF LABOR
ID
01
—
185456700
US DEPT OF LABOR
ID
01
—
8B305
BLUE CROSS OF IDAHO GROUP
ID
Enumeration date
03/06/2007
Last updated
06/10/2013
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