Organization
MCCALL PHYSICAL THERAPY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D BAILEY (OWNER)
(208) 634-3555
Entity
Organization
Contact information
Practice address
305 E PARK ST, MCCALL, ID 83638
(208) 634-3555
(208) 634-8793
Mailing address
305 E PARK ST, MCCALL, ID 83638
(208) 634-3555
(208) 634-8793
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06155
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TA872
BLUE CROSS
ID
Enumeration date
11/15/2006
Last updated
06/26/2008
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