Organization
HYDE PHYSICAL THERAPY
Active
Organization
HYDE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON R HYDE P.T. (OWNER/PHYSICAL THERAPIST)
(208) 227-6255
Entity
Organization
Contact information
Practice address
725 JENSEN GROVE DR, SUITE 4, BLACKFOOT, ID 83221-1636
(208) 785-3462
(208) 785-3453
Mailing address
725 JENSEN GROVE DR, SUITE 4, BLACKFOOT, ID 83221-1636
(208) 785-3462
(208) 785-3453
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1987
ID
Other
Enumeration date
10/22/2013
Last updated
10/22/2013
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