Organization
THERADY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID VANORDEN (PRESIDENT)
(208) 904-3311
Entity
Organization
Contact information
Practice address
1489 CENTER PARK DR, AMMON, ID 83406
(208) 904-3311
Mailing address
PO BOX 235, POCATELLO, ID 83204-0235
(208) 904-3311
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/20/2026
Last updated
03/20/2026
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