Organization
PEAK ACTION PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLIN RICO BENEDETTI DPT (OWNER/CEO)
(208) 251-9831
Entity
Organization
Contact information
Practice address
927 SAGEWOOD PL, POCATELLO, ID 83201-2719
(208) 251-9831
Mailing address
PO BOX 4269, POCATELLO, ID 83205-4269
(208) 251-9831
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-131
ID
Other
Enumeration date
04/27/2011
Last updated
04/27/2011
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