Organization
THE PHYSICAL THERAPY AND SPORTSMEDICINE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN M SCHWAB MA PT (OWNER)
(208) 356-6607
Entity
Organization
Contact information
Practice address
133 E MAIN ST, REXBURG, ID 83440-1911
(208) 356-6607
(208) 356-5835
Mailing address
133 E MAIN ST, REXBURG, ID 83440-1911
(208) 356-6607
(208) 356-5835
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
T-236
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1654675
MEDICARE GROUP NUMBER
ID
Enumeration date
12/17/2007
Last updated
12/17/2007
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