Organization
FUNCTIONAL PHYSICAL THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJCOOMAR ISSUREE P.T. (PHYSICAL THERAPIST/DIRECTOR)
(208) 376-7313
Entity
Organization
Contact information
Practice address
8950 W EMERALD ST, SUITE 195, BOISE, ID 83704-4854
(208) 376-7313
(208) 376-7487
Mailing address
8950 W EMERALD ST, SUITE 195, BOISE, ID 83704-4854
(208) 376-7313
(208) 376-7487
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT670
ID
Other
Enumeration date
10/31/2011
Last updated
04/16/2012
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