Organization
MORRIS PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK C MORRIS P.T., ATC (OWNER)
(208) 466-6959
Entity
Organization
Contact information
Practice address
1809 N BINGHAM DR, NAMPA, ID 83651-1764
(208) 466-6959
(208) 465-9901
Mailing address
1809 N BINGHAM DR, NAMPA, ID 83651-1764
(208) 466-6959
(208) 465-9901
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
RPT710
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311934
BLUE SHEILD
ID
05
—
805031000
—
ID
01
—
P00206064
GBA MEDICARE
ID
01
—
T7671
BLUE CROSS
ID
Enumeration date
11/20/2006
Last updated
12/15/2009
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