Organization
PHYSIO SHOP IDAHO LLC
Active
Organization
PHYSIO SHOP IDAHO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER L JOHNSON PT, DPT (PHYSICAL THERAPIST)
(208) 317-1736
Entity
Organization
Contact information
Practice address
2283 E 17TH ST, IDAHO FALLS, ID 83404
(208) 317-1736
Mailing address
2283 E 17TH ST, IDAHO FALLS, ID 83404
(208) 317-1736
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up