Organization
PRIMARY THERAPY SOURCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH JAN YINGST PT (OWNER)
(208) 734-7333
Entity
Organization
Contact information
Practice address
254 RIVER VISTA PL, TWIN FALLS, ID 83301
(208) 734-7333
(208) 734-8350
Mailing address
254 RIVER VISTA PL, TWIN FALLS, ID 83301
(208) 734-7333
(208) 734-8350
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/30/2007
Last updated
11/07/2007
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